Jump to content

Video:Cytomegalovirus and Epstein-Barr virus coinfection

From WikiProjectMed
Cytomegalovirus and Epstein-Barr virus coinfection (Tutorial)
Commons / NC
Steps for video creation
Step 1Preview my changes (10 sec)
Step 2Upload to Commons (10 min)

Edit with VisualEditor

Description

Cytomegalovirus and Epstein-Barr virus are both members of the herpesvirus family and can co-infect individuals, particularly those with weakened immune systems.EBV has a global seroprevalence rate of nearly 90 percent, while CMV is also highly prevalent, especially in certain populations such as pregnant women and immunocompromised individuals.Coinfection with EBV and CMV can complicate disease progression, modify immune responses, and make treatment difficult.[1][2]

Presentation

In terms of the presentation we find that immunocompromised individuals face a higher risk of severe manifestations of fever and lymphadenopathy, immunocompetent people also contract the co-infection including a more prolonged mononucleosis-like illness ; therefore presentations are not limited to those with weak immune systems.[3][4]

Complications

In terms of potential complications we find EBV and CMV coinfection can contribute to:[5] Post-transplant lymphoproliferative disorder, Hemophagocytic syndrome and hepatic issues.

Risk factors

In terms of risk factors that could bring about Cytomegalovirus and Epstein-Barr virus coinfection we find:[6][7] immunosuppression, older adults(> 60) and chronic liver disease.

Mechanism

As to mechanism we find that both viruses can establish latency and reactivate, especially during periods of immunosuppression. Co-infection increases the risk of managing viral reactivation in vulnerable populations like transplant recipients.[8][9]Both viruses can produce viral homologs of human cytokines(viral IL-10 from both CMV and EBV), which can suppress the host immune response, increasing susceptibility to other infections.[10][11][12]

Diagnosis

As to the evaluation we find that the most definitive way to diagnose a CMV and EBV co-infection is through blood tests that detect the presence of antibodies and/or the viruses themselves, these tests include:[13][14] Antibody test, Monospot test and PCR.

Treatment

In terms of management in immunocompromised individuals we find that ganciclovir and valganciclovir are used to treat CMV . Other antiviral drugs like foscarnet and cidofovir can be used, if the CMV strain is resistant to ganciclovir.[15][16] As to antiviral therapy for EBV in immunocompromised individuals can be considered in the context of EBV-related complications like post-transplant lymphoproliferative disorder; antivirals that suppress EBV replication might be used.[17]

Prevalence

In terms of prevalence we find that co-infection rates post-transplantation range from 2 (point) 6 to 32 (point) 7 percent and are associated with increased graft rejection and post-transplant lymphoproliferative disorder.[8]In Pakistan, a study found high rates of active EBV at 79 (point) 9 percent and CMV at 38 (point) 9 percent co-infection in children with HIV(immunocompromised individuals).[18]

History

As to history we find that the first observation of cells infected with CMV was made in 1881 by German pathologist Hugo Ribbert, who noticed enlarged cells with enlarged nuclei in an infant.[19]As to EBV was discovered in 1964 by Michael Anthony Epstein, Yvonne Barr, and Bert Achong through their work with Burkitt's lymphoma samples.[20]The discovery of CMV and EBV coinfection, is not a single discovery, but the result of research into both viruses individually and their prevalence in the population.Research into the prevalence of CMV and EBV coinfection has been ongoing through population-based studies, such as the one by Tiguman, et al(2020).[21]

Research

A 2023 article indicates that coinfection amplifies immune aging signatures, suggesting synergistic immune remodeling.Coinfected individuals cluster closer to immunosenescent profiles.[22]

References

  1. ↑ Ebrahimi, Fatemeh; Rasizadeh, Reyhaneh; Sharaflou, Shabnam; Aghbash, Parisa Shiri; Shamekh, Ali; Jafari-Sales, Abolfazl; Bannazadeh Baghi, Hossein (8 November 2024). "Coinfection of EBV with other pathogens: a narrative review". Frontiers in Virology. 4. doi:10.3389/fviro.2024.1482329. ISSN 2673-818X.
  2. ↑ de Melo Silva, Jean; Pinheiro-Silva, Renato; Dhyani, Anamika; Pontes, Gemilson Soares (2020). "Cytomegalovirus and Epstein-Barr Infections: Prevalence and Impact on Patients with Hematological Diseases". BioMed Research International. 2020 (1): 1627824. doi:10.1155/2020/1627824. ISSN 2314-6141.
  3. ↑ AlAmeen, Osamah; Mohammed, Areej; Faisal, Mohanad; Kohla, Samah; Abdulhadi, Ahmad (October 2023). "Co-infection of Cytomegalovirus and Epstein-Barr Virus in an Immunocompetent Patient: A Case Series and Literature Review". Cureus. 15 (10): e47599. doi:10.7759/cureus.47599. ISSN 2168-8184. PMC 10667022. PMID 38022095.
  4. ↑ Sánchez-Ponce, Yessica; Fuentes-Pananá, Ezequiel M. (19 July 2021). "The Role of Coinfections in the EBV-Host Broken Equilibrium". Viruses. 13 (7): 1399. doi:10.3390/v13071399. ISSN 1999-4915. PMC 8310153. PMID 34372605.
  5. ↑ Kato, Moe; Lee, Shin; Morishita, Tetsuji; Fujita, Kei; Tagami, Atsushi; Araki, Hiroshi; Sugihara, Jun-ichi (1 June 2022). "Hemophagocytic syndrome due to Epstein-Barr virus and cytomegalovirus coinfection in a patient on adalimumab". Journal of Infection and Chemotherapy. 28 (6): 823–827. doi:10.1016/j.jiac.2022.01.018. ISSN 1341-321X. PMID 35135708. Archived from the original on 9 August 2022. Retrieved 17 May 2025.
  6. ↑ Hu, Jianhua; Zhao, Hong; Lou, Danfeng; Gao, Hainv; Yang, Meifang; Zhang, Xuan; Jia, Hongyu; Li, Lanjuan (16 November 2018). "Human cytomegalovirus and Epstein-Barr virus infections, risk factors, and their influence on the liver function of patients with acute-on-chronic liver failure". BMC Infectious Diseases. 18 (1): 577. doi:10.1186/s12879-018-3488-8. ISSN 1471-2334. PMC 6240234. PMID 30445927.
  7. ↑ Sim, Beatrice Z.; Yong, Kar Yee; Slavin, Monica A.; Yong, Michelle K. (1 December 2022). "Risk factors and outcome of concurrent and sequential multiviral cytomegalovirus, Epstein-Barr virus, BK virus, adenovirus and other viral reactivations in transplantation". Current Opinion in Infectious Diseases. 35 (6): 536–544. doi:10.1097/QCO.0000000000000888. ISSN 1473-6527. PMID 36255049. Archived from the original on 6 February 2025. Retrieved 23 May 2025.
  8. ↑ 8.0 8.1 Anderson-Smits, Colin; Baker, Erin R.; Hirji, Ishan (December 2020). "Coinfection rates and clinical outcome data for cytomegalovirus and Epstein-Barr virus in post-transplant patients: A systematic review of the literature". Transplant Infectious Disease: An Official Journal of the Transplantation Society. 22 (6): e13396. doi:10.1111/tid.13396. ISSN 1399-3062. PMC 7816247. PMID 32603496.
  9. ↑ Zanella, Marie-Céline; Cordey, Samuel; Kaiser, Laurent (26 August 2020). "Beyond Cytomegalovirus and Epstein-Barr Virus: a Review of Viruses Composing the Blood Virome of Solid Organ Transplant and Hematopoietic Stem Cell Transplant Recipients". Clinical Microbiology Reviews. 33 (4): 10.1128/cmr.00027–20. doi:10.1128/cmr.00027-20. PMID 32847820. Archived from the original on 4 June 2024. Retrieved 18 May 2025.
  10. ↑ Trotta, Paul P.; Windsor, William T. (1995). "Physicochemical and Structural Properties of Interleukin-10". Interleukin-10. Springer. pp. 11–18. doi:10.1007/978-3-662-22038-2_2. ISBN 978-3-662-22038-2. Archived from the original on 2018-06-10. Retrieved 2025-05-23.
  11. ↑ Jog, Neelakshi R.; Chakravarty, Eliza F.; Guthridge, Joel M.; James, Judith A. (2018). "Epstein Barr Virus Interleukin 10 Suppresses Anti-inflammatory Phenotype in Human Monocytes". Frontiers in Immunology. 9: 2198. doi:10.3389/fimmu.2018.02198. ISSN 1664-3224. PMC 6189329. PMID 30356670.
  12. ↑ Kotenko, Sergei V.; Saccani, Simona; Izotova, Lara S.; Mirochnitchenko, Olga V.; Pestka, Sidney (15 February 2000). "Human cytomegalovirus harbors its own unique IL-10 homolog (cmvIL-10)". Proceedings of the National Academy of Sciences. 97 (4): 1695–1700. Bibcode:2000PNAS...97.1695K. doi:10.1073/pnas.97.4.1695. PMC 26498. PMID 10677520.
  13. ↑ Jhaveri, Tulip A.; Harris, Courtney; Sax, Paul E. (July 2022). "IgM Positivity for Both EBV and CMV: A Clinical Conundrum". Open Forum Infectious Diseases. 9 (7): ofac316. doi:10.1093/ofid/ofac316. ISSN 2328-8957. PMC 9297312. PMID 35873288.
  14. ↑ "Laboratory Testing for Epstein-Barr Virus (EBV)". Epstein-Barr Virus and Infectious Mononucleosis. 10 April 2024. Archived from the original on 29 March 2025. Retrieved 15 May 2025.
  15. ↑ Walti, Carla Simone; Khanna, Nina; Avery, Robin K.; Helanterä, Ilkka (12 October 2023). "New Treatment Options for Refractory/Resistant CMV Infection". Transplant International. 36: 11785. doi:10.3389/ti.2023.11785. ISSN 1432-2277. PMC 10600348. PMID 37901297.
  16. ↑ Schmitz, Jena; Gaskill, Eric; Price, Samantha; Cao, Biwei; Kim, Jongphil; Baluch, Aliyah; Klinkova, Olga; Faramand, Rawan; Mishra, Asmita; Perez, Lia; Khimani, Farhad; Lazaryan, Aleksandr; Ochoa-Bayona, Jose L.; Liu, Hien; Mirza, Sayeef; Nieder, Michael; Anasetti, Claudio; Nishihori, Taiga; Pidala, Joseph A.; Bejanyan, Nelli; Elmariah, Hany (5 November 2024). "Letermovir Prophylaxis Reduces the Risk of Cytomegalovirus Infection in HLA-Matched and Mismatched Allogeneic Hematopoietic Cell Transplant Patients Receiving Post-Transplant Cyclophosphamide". Blood. 144 (Supplement 1): 2130. doi:10.1182/blood-2024-209164. ISSN 0006-4971.
  17. ↑ Chakravorty, Srishti; Afzali, Behdad; Kazemian, Majid (27 October 2022). "EBV-associated diseases: Current therapeutics and emerging technologies". Frontiers in Immunology. 13. doi:10.3389/fimmu.2022.1059133. ISSN 1664-3224. PMC 9647127. PMID 36389670.
  18. ↑ Nazim, Fizza; Kayani, Hammad Afzal; Ali Nathwani, Apsara; Mir, Fatima; Abidi, Syed Hani (19 August 2022). "CMV and EBV Co-Infection in HIV-Infected Children: Infection Rates and Analysis of Differential Expression of Cytokines in HIV Mono- and HIV-CMV-EBV Co-Infected Groups". Viruses. 14 (8): 1823. doi:10.3390/v14081823. ISSN 1999-4915. PMC 9414517. PMID 36016445.
  19. ↑ "Cytomegalovirus - Background | Occupational Safety and Health Administration". www.osha.gov. Archived from the original on 20 April 2025. Retrieved 19 May 2025.
  20. ↑ Smith, Emma (26 March 2014). "50 years of Epstein-Barr virus". Cancer Research UK - Cancer News. Archived from the original on 5 December 2024. Retrieved 19 May 2025.
  21. ↑ Tiguman, Gustavo Magno Baldin; Poll, Laura Beatrice; Alves, Carlos Eduardo de Castro; Pontes, Gemilson Soares; Silva, Marcus Tolentino; Galvao, Tais Freire (2020). "Seroprevalence of cytomegalovirus and its coinfection with Epstein-Barr virus in adult residents from Manaus: a population-based study". Revista da Sociedade Brasileira de Medicina Tropical. 53: e20190363. doi:10.1590/0037-8682-0363-2019. ISSN 1678-9849. PMC 7083370. PMID 31994666.
  22. ↑ Hofstee, Marloes I.; Cevirgel, Alper; de Zeeuw-Brouwer, Mary-Lène; de Rond, Lia; van der Klis, Fiona; Buisman, Anne-Marie (5 July 2023). "Cytomegalovirus and Epstein–Barr virus co-infected young and middle-aged adults can have an aging-related T-cell phenotype" (PDF). Scientific Reports. 13 (1). doi:10.1038/s41598-023-37502-5.
Retrieved from "https://mdwiki.org/w/index.php?title=Video:Cytomegalovirus_and_Epstein-Barr_virus_coinfection&oldid=1488564"