Patel Sangram Singh, Singh Sweta, Sahu Chinmoy, Ghoshal Ujjala, Verma Hemant
Department of Microbiology, SGPGIMS, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2021 Jan;10(1):373-377. doi: 10.4103/jfmpc.jfmpc_1594_20. Epub 2021 Jan 30.
Epstein-Barr virus (EBV) is a member of the family Gamma Herpes viridae and is usually implicated in malignancies like non-Hodgkin's lymphoma, Hodgkin's lymphoma and Burkitt's lymphoma. The present study was designed with the aim to estimate the seroprevalence of EBV in people with hematological malignancies and further follow up was planned by viral load quantitation by Real time PCR in positive cases.
The current study was planned for a period of three years and a total of 272 serum samples were tested from patients with hematological malignancies namely; HL, NHL, ALL, CLL. Serological testing was performed for the presence of IgM and IgG antibodies against EBV viral capsid antigen. Sera of the patients found positive for IgM was further subjected to viral DNA extraction and Real Time Quantitative PCR was performed by a commercial kit.
The overall seropositivity rate was 89.2% for EBV IgG antibodies and 56.1% for IgM antibodies. The seroprevalence for anti-EBV VCA IgM was found to be highest in the age group <10 years (34.8%) and 11-22 years (20.4%). Of the 109 EBV positive strains by PCR, 27.3% were HL, 35.2% NHL, 24.3% ALL and 13.7% were CLL. The mean viral load was 68.7 × 10 copies/ml DNA.
Our study showed a higher seroprevalence and a definite causal relationship of EBV in lymphoma patients. Young adults showed a higher risk of hematological malignancies as compared to elder population. This study can prove to be an essential guide and aid to the primary care physicians in identifying the possible risk factors and seroprevalence in various age groups of EBV malignancy patients for their proper follow up and referral to higher speciality centres.
爱泼斯坦-巴尔病毒（EBV）是γ疱疹病毒科的成员，通常与非霍奇金淋巴瘤、霍奇金淋巴瘤和伯基特淋巴瘤等恶性肿瘤有关。本研究旨在估计血液系统恶性肿瘤患者中EBV的血清流行率，并计划对阳性病例通过实时PCR进行病毒载量定量进一步随访。
本研究计划为期三年，共检测了272份血液系统恶性肿瘤患者的血清样本，这些患者包括霍奇金淋巴瘤（HL）、非霍奇金淋巴瘤（NHL）、急性淋巴细胞白血病（ALL）、慢性淋巴细胞白血病（CLL）。进行血清学检测以确定针对EBV病毒衣壳抗原的IgM和IgG抗体的存在情况。IgM检测呈阳性的患者血清进一步进行病毒DNA提取，并使用商用试剂盒进行实时定量PCR。
EBV IgG抗体的总体血清阳性率为89.2%，IgM抗体为56.1%。抗EBV VCA IgM的血清流行率在年龄小于10岁组（34.8%）和11 - 22岁组（20.4%）中最高。在通过PCR检测的109株EBV阳性菌株中，27.3%为HL，35.2%为NHL，24.3%为ALL，13.7%为CLL。平均病毒载量为68.7×10拷贝/ml DNA。
我们的研究表明淋巴瘤患者中EBV的血清流行率较高且存在明确的因果关系。与老年人群相比，年轻人患血液系统恶性肿瘤的风险更高。本研究可成为初级保健医生识别EBV恶性肿瘤患者不同年龄组可能的危险因素和血清流行率的重要指南和辅助工具，以便进行适当的随访并转诊至更高专科中心。
