EBV
Meaning of EBV: One of the most widespread viruses in existence, harmless in most people and yet tied to a surprising list of diseases.
Definition of EBV
EBV stands for Epstein-Barr virus, a herpes virus that infects most people worldwide, usually during childhood and without symptoms. It settles permanently in B lymphocytes and remains for life, held in check by the immune system. Caught later, in adolescence or adulthood, it commonly causes infectious mononucleosis, and it is linked to several cancers and to multiple sclerosis.
How does it stay for life?
The virus enters through the mouth, multiplies in the lining of the throat, then infects B lymphocytes, the white cells that make antibodies. Inside them it does something unusual. It stops producing new virus and quiets its genes almost completely, becoming invisible to the immune system. Those resting cells persist indefinitely, and the virus reactivates from time to time, shedding into saliva. Most reactivation causes no symptoms at all, and it is how the virus spreads, which is why glandular fever picked up the nickname the kissing disease.
What does a first infection look like?
Age decides almost everything. A young child usually notices nothing. Someone meeting the virus in adolescence or later often develops infectious mononucleosis, with a severe sore throat, swollen glands, marked fatigue and an enlarged spleen. The symptoms come from the immune response rather than from the virus damaging tissue, since huge numbers of T cells expand to control the infected B cells. Fatigue can outlast the other features by weeks. An enlarged spleen is the reason contact sport is avoided during recovery.
What is it linked to?
| Condition | Nature of the link |
|---|---|
| Burkitt lymphoma | Strong in the form common in equatorial Africa, alongside malaria |
| Nasopharyngeal carcinoma | Nearly all cases carry the virus, with diet and genetics also involved |
| Hodgkin lymphoma | The virus is present in a substantial share of cases |
| Lymphoma after transplant | Infected B cells multiply unchecked when immunity is suppressed |
| Multiple sclerosis | Large studies indicate that earlier infection is a necessary step |
Since almost everyone carries the virus and very few develop any of these, infection alone is plainly not sufficient. Other factors decide, which is why Burkitt lymphoma and Hodgkin lymphoma are nowhere near inevitable consequences.
How is it detected?
A rapid test looks for antibodies that clump animal red cells, a peculiar side effect of the immune response, although it can read negative early on and in young children. Antibody tests aimed at specific viral proteins separate recent infection from past infection. Counting viral DNA in blood is used where the risk of lymphoma after transplantation is being watched. No vaccine is in routine use, and no antiviral drug clears the virus from the body.
Also known as
Used in a sentence
Serology confirmed recent EBV infection in a young adult with sore throat and cervical lymphadenopathy.
Good to know
Nearly everyone carries Epstein-Barr virus for life, so an antibody test showing past infection is an ordinary finding and does not by itself account for current symptoms.