Ministério da Saúde, Secretaria de Vigilância em Saúde, Instituto Evandro Chagas, Ananindeua, PA, Brazil; Instituto Evandro Chagas, Pós-graduação em Virologia, (PPGV/IEC), Ananindeua, PA, Brazil.
Ministério da Saúde, Secretaria de Vigilância em Saúde, Instituto Evandro Chagas, Ananindeua, PA, Brazil.
Braz J Infect Dis. 2020 Jul-Aug;24(4):322-329. doi: 10.1016/j.bjid.2020.06.004. Epub 2020 Jun 30.
Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans. Although their genomes are similar, the regions containing the EBNA genes differ. This study aimed to characterize the EBV genotypes of infectious mononucleosis (IM) cases in the metropolitan region of Belém, Brazil, from 2005 to 2016. A total of 8295 suspected cases with symptoms/signs of IM were investigated by infectious disease physicians at Evandro Chagas Institute, Health Care Service, from January 2005 to December 2016. Out of the total, 1645 (19.8%) samples had positive results for EBV by enzyme immunoassay and 251 (15.3%) were submitted to polymerase chain reaction (PCR) technique, using the EBNA3C region, in order to determine the type of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were also performed. EBV type was identified by PCR in 30.3% (76/251) of individuals; of those, 71.1% (54/76) were classified as EBV1, 17.1% (13/76) as EBV2, and 11.8% (9/76) as EBV1 + EBV2. The main symptoms/signs observed with EBV1 infection were cervical lymphadenopathy (64.8%, 35/54), fever (63%, 34/54), headache (20.4%, 11/54), arthralgia (20.4%, 11/54), and exanthema (18.5%, 10/54). EBV2 infection was detected in all but two age groups, with an average age of 24 years. The most common signs/symptoms of EBV2 were fever (76.9%, 10/13), average duration of 18 days, and lymphadenopathy (69.2%, 9/13). In contrast, EBV1 + EBV2 coinfections were more frequent in those aged five years or less (20.0%, 2/10). The symptoms of EBV1 + EBV2 coinfection included fever (66.7%, 6/9), and cervical lymphadenopathy and headache (33.3%, 3/9) each. The mean values of hepatic enzymes according to type of EBV was significantly different (p < 0.05) in those EBV1 infected over 14 years of age. Thus, this pioneering study, using molecular methods, identified the EBV genotypes in 30.3% of the samples, with circulation of EBV1, EBV2, and EBV1 + EBV2 co-infection in cases of infectious mononucleosis in the northern region of Brazil.
两种类型的 Epstein Barr 病毒 (EBV1/EBV2) 已被证明可感染人类。尽管它们的基因组相似，但包含 EBNA 基因的区域有所不同。本研究旨在分析巴西贝伦大都会区 2005 年至 2016 年传染性单核细胞增多症 (IM) 病例的 EBV 基因型。2005 年 1 月至 2016 年 12 月期间，伊瓦德罗·查加斯研究所的传染病医生对 8295 例疑似有 IM 症状/体征的患者进行了调查。其中，1645 例（19.8%）通过酶免疫分析法对 EBV 呈阳性结果，251 例（15.3%）采用聚合酶链反应（PCR）技术，使用 EBNA3C 区域，以确定 EBV 的类型。还进行了涉及天门冬氨酸氨基转移酶、丙氨酸氨基转移酶和γ-谷氨酰转移酶的生化检测。在 30.3%（76/251）的个体中通过 PCR 鉴定出 EBV 类型；其中，71.1%（54/76）为 EBV1，17.1%（13/76）为 EBV2，11.8%（9/76）为 EBV1+EBV2。EBV1 感染的主要症状/体征是颈淋巴结病（64.8%，35/54）、发热（63%，34/54）、头痛（20.4%，11/54）、关节炎（20.4%，11/54）和皮疹（18.5%，10/54）。除了两个年龄组外，均检测到 EBV2 感染，平均年龄为 24 岁。EBV2 感染的最常见症状/体征为发热（76.9%，10/13），平均持续时间为 18 天，淋巴结病（69.2%，9/13）。相比之下，5 岁或以下儿童中 EBV1+EBV2 混合感染更为常见（20.0%，2/10）。EBV1+EBV2 混合感染的症状包括发热（66.7%，6/9）、颈淋巴结病和头痛（各 33.3%，3/9）。根据 EBV 类型，年龄在 14 岁以上 EBV1 感染患者的肝酶均值有显著差异（p<0.05）。因此，本研究使用分子方法，在巴西北部地区的传染性单核细胞增多症病例中，发现了 30.3%的 EBV 基因型，存在 EBV1、EBV2 和 EBV1+EBV2 混合感染。
