Epstein barr virus food. Antiviral drug Acyclovir. What are the symptoms of Epstein-Barr igg virus?

Epstein-Barr virus (EBV). Symptoms, diagnosis, treatment in children and adults

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Epstein-Barr virus is a virus that belongs to the herpes family of viruses, the 4th type of herpes infection, is able to infect lymphocytes and other immune cells, the mucous membrane of the upper respiratory tract, neurons of the central nervous system and almost all internal organs. In the literature, you can find the abbreviation VEB or VEB - infection.

Possible abnormalities in liver function tests in infectious mononucleosis:

1. 
   Increased transaminase levels several times:
   • ALT norm 10-40 IU/l,
   
   
   • AST norm 20-40 IU / l.
   
   
2. Increase in thymol test - the norm is up to 5 units.


3. Moderate increase in total bilirubin due to unbound or direct: the norm of total bilirubin is up to 20 mmol / l.


4. Increased alkaline phosphatase - the norm is 30-90 IU / l.

A progressive increase in indicators and an increase in jaundice may indicate the development of toxic hepatitis, as a complication of infectious mononucleosis. This condition requires intensive care.

Epstein-Barr virus treatment

There is still no consensus among physicians and scientists regarding the methods of treatment, and a large number of studies are currently being carried out regarding antiviral treatment. At the moment, there are no specific drugs effective against the Epstein-Barr virus.

Infectious mononucleosis is an indication for inpatient treatment, with further recovery at home. Although with a mild course, hospitalization in the hospital can be avoided.

In the acute period of infectious mononucleosis, it is important to observe sparing regimen and diet:

• semi-bed rest, restriction of physical activity,


• need to drink plenty of water


• meals should be frequent, balanced, in small portions,


• exclude fried, spicy, smoked, salty, sweet foods,


• fermented milk products have a good effect on the course of the disease,


• the diet should contain a sufficient amount of proteins and vitamins, especially C, group B,


• refuse products containing chemical preservatives, dyes, flavor enhancers,


• it is important to exclude foods that are allergens: chocolate, citrus fruits, legumes, honey, some berries, out-of-season fresh fruits, and others.

For chronic fatigue syndrome useful will be:

• normalization of the mode of work, sleep and rest,


• positive emotions, doing what you love,


• complete nutrition,


• multivitamin complex.

Epstein-Barr virus drug treatment

The principles of treatment of EBV infection in children and adults are the same, the difference is only in the recommended age dosages.

Treatment of the Epstein-Barr virus is selected individually depending on the severity of the course, the manifestations of the disease, the state of the patient's immunity and the presence of concomitant pathologies.

Principles of drug treatment of chronic fatigue syndrome

• Antiviral drugs: Acyclovir, Gerpevir, Interferons,


• vascular drugs: Actovegin, Cerebrolysin,


• drugs that protect nerve cells from the effects of the virus: Glycine, Encephabol, Instenon,



• sedatives,


• multivitamins.

Epstein-Barr virus treatment with folk remedies

1. Echinacea tincture - 3-5 drops (for children over 12 years old) and 20-30 drops for adults 2-3 times a day before meals.


2. Ginseng tincture - 5-10 drops 2 times a day.


3. herbal collection (not recommended for pregnant women and children under 12):
   
   
   • Chamomile flowers,
   
   
   • Peppermint,
   
   
   • Ginseng,
   
   
   
   • Marigold flowers.
   Take herbs in equal proportions, stir. To brew tea, 1 tablespoon is poured into 200.0 ml of boiling water and brewed for 10-15 minutes. Taken 3 times a day.


4. Green tea with lemon, honey and ginger - increases the body's defenses.


5. fir oil - used externally, lubricate the skin over enlarged lymph nodes.


6. Raw egg yolk: every morning on an empty stomach for 2-3 weeks, improves liver function and contains a large amount of nutrients.


7. Magonia Root or Oregon Grape Berries - add to tea, drink 3 times a day.

Which doctor should I contact with the Epstein-Barr virus?

If infectious mononucleosis becomes a generalized infection, you should immediately call an ambulance and be hospitalized in the intensive care unit (reanimation).

Frequently asked Questions

How does the Epstein-Barr virus affect pregnancy?

• Class immunoglobulins discovered G( VCA and EBNA) - you can easily plan a pregnancy, with good immunity, the reactivation of the virus is not terrible.


• Positive immunoglobulins class M - with the conception of a baby, you will have to wait until complete recovery, confirmed by an analysis for antibodies to EBV.


• There are no antibodies to the Epstein-Barr virus in the blood - it is possible and necessary to become pregnant, but you will have to be observed, periodically taking tests. You also need to protect yourself from possible infection with EBV during the gestation period, strengthen your immunity.

If class M antibodies are detected during pregnancy to the Epstein-Barr virus, then the woman must be hospitalized in a hospital until complete recovery, the necessary symptomatic treatment is carried out, antiviral drugs are prescribed, and immunoglobulins are administered.

How exactly the Epstein-Barr virus affects pregnancy and the fetus is not yet fully understood. But many studies have shown that pregnant women with active EBV infection are much more likely to have pathologies in the child they are carrying. But this does not mean at all that if a woman had an active Epstein-Barr virus during pregnancy, then the child should be born unhealthy.

Possible complications of the Epstein-Barr virus on pregnancy and fetus:

• premature pregnancy (miscarriage),


• stillbirth,


• intrauterine growth retardation (IUGR), fetal hypotrophy,


• prematurity,


• postpartum complications: uterine bleeding, DIC, sepsis,


• possible malformations of the central nervous system of the child (hydrocephalus, underdevelopment of the brain, etc.) associated with the action of the virus on the nerve cells of the fetus.

Can the Epstein-Barr virus be chronic?

1. Infection followed by an active period of the virus (acute viral EBV infection or infectious mononucleosis);


2. Recovery, in which the virus goes into an inactive state , in this form, the infection can exist in the body for life;


3. Chronic viral infection Epstein-Barr - characterized by reactivation of the virus, which occurs during periods of reduced immunity, manifests itself in the form of various diseases (chronic fatigue syndrome, changes in immunity, oncological diseases, and so on).

What are the symptoms of the Epstein-Barr igg virus?

Thus, the entire record "Epstein-Barr virus igg" means that we are talking about the presence in the human body of antibodies of the IgG type to the virus. Currently, the human body can produce several types of IgG antibodies to different parts of the body. Epstein-Barr virus, such as:

• IgG to the capsid antigen (VCA) – anti-IgG-VCA;
• IgG to early antigens (EA) - anti-IgG-EA;
• IgG to nuclear antigens (EBNA) - anti-IgG-NA.

But the detection of antibodies such as anti-IgG-EA may indicate an active course of a chronic infection, which is accompanied by clinical symptoms. Thus, under the entry "Epstein-Barr igg virus" in relation to symptoms, doctors understand precisely the presence in the body of antibodies of the anti-IgG-EA type. That is, we can say that the concept of "Epstein-Barr igg virus" in short form indicates that a person has symptoms of a chronic infection caused by a microorganism.

Symptoms of a chronic Epstein-Barr virus infection (EBSI, or chronic fatigue syndrome) are as follows:

• Prolonged low-grade fever;
• Low performance;
• Causeless and inexplicable weakness;
• Enlarged lymph nodeslocated in various parts of the body;
• sleep disorders;
• Recurrent angina.

In addition, chronic EBV can lead to the formation of some tumors, such as:

• Nasopharyngeal carcinoma;
• Burkitt's lymphoma;
• Neoplasms of the stomach and intestines;
• Hairy leukoplakia of the mouth;
• Thymoma (tumor of the thymus), etc.

What diseases can be caused by the Epstein-Barr virus? What are the typical symptoms of EBV infection?

Are there strictly specific for EBV changes in laboratory parameters?

What does complex therapy for EBV infection include?

In recent years, there has been an increase in the number of patients suffering from chronic recurrent infections, which in many cases are accompanied by a pronounced violation of general well-being and a number of therapeutic complaints. The most common in clinical practice (most often caused by Herpes Simplex I), (Herpes zoster) and (more often caused by Herpes simplex II); in transplantology and gynecology, diseases and syndromes caused by cytomegalovirus (Cytomegalovirus) are common. However, general practitioners are clearly not well aware of the chronic infection caused by the Epstein-Barr virus (EBV) and its forms.

EBV was first isolated from Burkett's lymphoma cells 35 years ago. It soon became known that the virus can cause acute and acute in humans. It has now been established that EBV is associated with a number of oncological, mainly lymphoproliferative and autoimmune diseases (classic, etc.). In addition, EBV can cause chronic manifest and erased forms of the disease, proceeding according to the type of chronic mononucleosis. The Epstein-Barr virus belongs to the family of herpes viruses, the subfamily of gamma-herpes viruses and the genus of lymphocriptoviruses, contains two DNA molecules and has the ability, like other viruses of this group, to persist for life in the human body. In some patients, against the background of immune dysfunction and hereditary predisposition to a particular pathology, EBV can cause various diseases, which were mentioned above. EBV infects a person by penetrating through intact epithelial layers by transcytosis into the underlying lymphoid tissue of the tonsils, in particular B-lymphocytes. The penetration of EBV into B-lymphocytes is carried out through the receptor of these cells CD21 - the receptor for the C3d component of complement. After infection, the number of affected cells increases through virus-dependent cell proliferation. Infected B-lymphocytes can reside in tonsillar crypts for a significant time, which allows the virus to be released into the external environment with saliva.

With infected cells, EBV spreads to other lymphoid tissues and peripheral blood. The maturation of B-lymphocytes into plasma cells (which normally occurs when they encounter the corresponding antigen, infection) stimulates the reproduction of the virus, and the subsequent death (apoptosis) of these cells leads to the release of viral particles into crypts and saliva. In virus-infected cells, two types of reproduction are possible: lytic, that is, leading to death, lysis, of the host cell, and latent, when the number of viral copies is small and the cell is not destroyed. EBV can be present in B-lymphocytes and epithelial cells of the nasopharyngeal region and salivary glands for a long time. In addition, it is able to infect other cells: T-lymphocytes, NK cells, macrophages, neutrophils, vascular epithelial cells. In the nucleus of the host cell, EBV DNA can form a circular structure, the episome, or integrate into the genome, causing chromosomal abnormalities.

In acute or active infection, lytic viral replication predominates.

Active reproduction of the virus can occur as a result of a weakening of immunological control, as well as stimulation of the reproduction of cells infected with the virus under the influence of a number of reasons: acute bacterial or viral infection, vaccination, stress, etc.

According to most researchers, today approximately 80-90% of the population is infected with EBV. Primary infection often occurs in childhood or young age. The ways of transmission of the virus are different: airborne, contact-household, transfusion, sexual, transplacental. After infection with EBV, virus replication in the human body and the formation of an immune response can be asymptomatic or manifest as minor signs of SARS. But if a large amount of the infection enters and / or there is a significant weakening of the immune system during this period, the patient may develop a picture of infectious mononucleosis. There are several options for the outcome of an acute infectious process:

• recovery (DNA of the virus can be detected only with a special study in single B-lymphocytes or epithelial cells);
• asymptomatic virus carrying or latent infection (the virus is detected in saliva or lymphocytes with a sensitivity of the PCR method of 10 copies per sample);
• chronic recurrent infection: a) chronic active EBV infection of the type of chronic infectious mononucleosis; b) a generalized form of chronic active EBV infection with damage to the central nervous system, myocardium, kidneys, etc.; c) EBV-associated hemophagocytic syndrome; d) erased or atypical forms of EBV infection: prolonged subfebrile condition of unknown origin, clinic - recurrent bacterial, fungal, often mixed infections of the respiratory and gastrointestinal tract, and other manifestations;
• development of an oncological (lymphoproliferative) process (multiple polyclonal, nasopharyngeal carcinoma, leukoplakia of the tongue and mucous membranes of the oral cavity, and intestines, etc.);
• the development of an autoimmune disease -, etc. (it should be noted that the last two groups of diseases can develop over a long period of time after infection);
• according to the results of our laboratory research (and based on a number of foreign publications), we concluded that EBV can play an important role in the occurrence.

The immediate and long-term prognosis for a patient with an acute infection caused by EBV depends on the presence and severity of immune dysfunction, genetic predisposition to certain EBV-associated diseases (see above), as well as on the presence of a number of external factors (stress, infection, surgical interventions, adverse environmental effects), damaging the immune system. EBV has been found to have a large set of genes that enable it to elude the human immune system to some extent. In particular, EBV produces proteins that are analogues of a number of human interleukins and their receptors that change the immune response. During the period of active reproduction, the virus produces an IL-10-like protein that suppresses T-cell immunity, the function of cytotoxic lymphocytes, macrophages, and disrupts all stages of the functioning of natural killers (that is, the most important antiviral defense systems). Another viral protein (BI3) can also suppress T-cell immunity and block the activity of killer cells (through downregulation of interleukin-12). Another property of EBV, as well as other herpes viruses, is its high mutability, which allows it to avoid the effects of specific immunoglobulins (which were produced for the virus before its mutation) and cells of the host's immune system for a certain time. Thus, the reproduction of EBV in the human body can be the cause of the aggravation (appearance) of secondary immunodeficiency.

Clinical forms of chronic infection caused by the Epstein-Barr virus

Chronic active EBV infection (HA EBV) is characterized by a long relapsing course and the presence of clinical and laboratory signs of viral activity. Patients are concerned about weakness, sweating, often pain in the muscles and joints, the presence of skin rashes, coughing, difficulty in nasal breathing, discomfort in the throat, pain, heaviness in the right hypochondrium, headaches that were previously uncharacteristic for this patient, dizziness, emotional lability, depressive disorders , sleep disturbance, memory loss, attention, intelligence. Subfebrile temperature, swollen lymph nodes, hepatosplenomegaly of varying severity are often observed. Often this symptomatology has a wave-like character. Sometimes patients describe their condition as a chronic flu.

In a significant proportion of patients with HA VEBI, the addition of other herpetic, bacterial and fungal infections (, inflammatory diseases of the upper respiratory tract and gastrointestinal tract) is observed.

HA VEBI is characterized by laboratory (indirect) signs of viral activity, namely relative and absolute lymphomonocytosis, the presence of atypical mononuclear cells, less often monocytosis and lymphopenia, in some cases anemia and thrombocytosis. In the study of the immune status in patients with HA EBV, there are changes in the content and function of specific cytotoxic lymphocytes, natural killers, a violation of a specific humoral response (dysimmunoglobulinemia, a long-term absence of immunoglobulin G (IgG) production or the so-called lack of seroconversion to the late nuclear antigen of the virus - EBNA, which reflects In addition, according to our data, more than half of the patients have reduced ability to stimulated production of interferon (IFN), elevated serum IFN levels, dysimmunoglobulinemia, impaired avidity of antibodies (their ability to bind firmly to antigen), reduced the content of DR + lymphocytes, the indicators of circulating immune complexes and antibodies to DNA are often increased.

In persons with severe immune deficiency, generalized forms of EBV infection may occur with damage to the central and peripheral nervous systems (development, encephalitis, cerebellar ataxia, polyradiculoneuritis), as well as damage to other internal organs (development, lymphocytic interstitial pneumonitis, severe forms). Generalized forms of EBV infection often end in death.

EBV-associated hemophagocytic syndrome is characterized by the development of anemia or pancytopenia. Often combined with HA VEBI, infectious mononucleosis and lymphoproliferative diseases. The clinical picture is dominated by intermittent fever, hepatosplenomegaly, lymphadenopathy, pancytopenia or severe anemia, hepatic dysfunction, coagulopathy. Hemophagocytic syndrome, which develops against the background of infectious mononucleosis, is characterized by high mortality (up to 35%). The above changes are explained by hyperproduction of pro-inflammatory cytokines (TNF, IL1 and a number of others) by T-cells infected with the virus. These cytokines activate the phagocyte system (reproduction, differentiation and functional activity) in the bone marrow, peripheral blood, liver, spleen, and lymph nodes. Activated monocytes and histiocytes begin to absorb blood cells, which leads to their destruction. More subtle mechanisms of these changes are under study.

Erased variants of chronic EBV infection

According to our data, HA VEBI often proceeds in a subtle way or under the guise of other chronic diseases.

There are two most common forms of latent flaccid EBV infection. In the first case, patients are concerned about prolonged low-grade fever of unknown origin, weakness, pain in the peripheral lymph nodes, myalgia, arthralgia. The undulation of symptoms is also characteristic. In another category of patients, in addition to the complaints described above, there are markers of secondary immunodeficiency in the form of frequent infections of the respiratory tract, skin, gastrointestinal tract, and genitals that were previously uncharacteristic for them, which do not completely disappear during therapy or quickly recur. Most often in the anamnesis of these patients there are long-term stressful situations, excessive mental and physical overload, less often - fasting, trendy diets, etc. Often, the above condition developed after suffering a sore throat, acute respiratory infections, influenza-like illness. Characteristic for this variant of infection are also the stability and duration of symptoms - from six months to 10 years or more. Repeated examinations detect EBV in saliva and/or peripheral blood lymphocytes. As a rule, repeated in-depth examinations conducted in most of these patients do not allow us to detect other causes of prolonged subfebrile condition and the development of secondary immunodeficiency.

Very important for the diagnosis of HA VEBI is the fact that in the case of stable suppression of viral replication, it is possible to achieve long-term remission in most patients. Diagnosis of CA VEBI is difficult due to the lack of specific clinical markers of the disease. A certain “contribution” to underdiagnosis is also made by the lack of awareness of practitioners about this pathology. However, given the progressive nature of CA VEBI, as well as the severity of the prognosis (the risk of developing lymphoproliferative and autoimmune diseases, high mortality in the development of hemophagocytic syndrome), if CA VEBI is suspected, it is necessary to conduct an appropriate examination. The most characteristic clinical symptom complex in HA VEBI is prolonged subfebrile condition, weakness and decreased performance, sore throat, lymphadenopathy, hepatosplenomegaly, hepatic dysfunction, and mental disorders. An important symptom is the lack of a full clinical effect from the generally accepted therapy for asthenic syndrome, restorative therapy, as well as from the appointment of antibacterial drugs.

When conducting a differential diagnosis of HA VEBI, the following diseases should be excluded first of all:

• other intracellular, including viral infections: HIV, viral hepatitis, cytomegalovirus infection, toxoplasmosis, etc.;
• rheumatic diseases, including those associated with EBV infection;
• oncological diseases.

Laboratory studies in the diagnosis of EBV infection

• CBC: there may be slight leukocytosis, lymphomonocytosis with atypical mononuclear cells, in some cases hemolytic anemia due to hemophagocytic syndrome or autoimmune anemia, possibly thrombocytopenia or thrombocytosis.
• Biochemical analysis of blood: an increase in the level of transaminases, LDH and other enzymes, acute phase proteins, such as CRP, fibrinogen, etc., are detected.

As mentioned above, all of these changes are not strictly specific for EBV infection (they can be found in other viral infections as well).

• Immunological examination: it is desirable to assess the main indicators of antiviral protection: the state of the interferon system, the level of immunoglobulins of the main classes, the content of cytotoxic lymphocytes (CD8+), T-helpers (CD4+).

According to our data, there are two types of changes in the immune status in EBV infection: increased activity of certain parts of the immune system and/or imbalance and insufficiency of others. Signs of tension in antiviral immunity can be elevated levels of IFN in the blood serum, IgA, IgM, IgE, CEC, often - the appearance of antibodies to DNA, an increase in the content of natural killers (CD16+), T-helpers (CD4+) and / or cytotoxic lymphocytes (CD8+) . The phagocyte system can be activated.

In turn, immune dysfunction/deficiency in this infection is manifested by a decrease in the ability to stimulate the production of IFN alpha and/or gamma, dysimmunoglobulinemia (decrease in the content of IgG, less often IgA, an increase in the content of Ig M), a decrease in the avidity of antibodies (their ability to bind strongly to the antigen) , a decrease in the content of DR + lymphocytes, CD25 + lymphocytes, that is, activated T cells, a decrease in the number and functional activity of natural killers (CD16+), T-helpers (CD4+), cytotoxic T-lymphocytes (CD8+), a decrease in the functional activity of phagocytes and / or change (perversion) of their response to stimuli, including immunocorrectors.

• Serological studies: an increase in antibody titers (AT) to antigens (AG) of the virus is a criterion for the presence of an infectious process at the present time or evidence of contact with the infection in the past. In acute EBV infection, depending on the stage of the disease, different classes of antibodies to the antigen of the virus are determined in the blood, and “early” antibodies change to “late” ones.

Specific IgM antibodies appear in the acute phase of the disease or during an exacerbation and usually disappear after four to six weeks. IgG-AT to EA (early) also appear in the acute phase, are markers of active viral replication, and decrease during recovery in three to six months. IgG-AT to VCA (early) are determined in the acute period with a maximum by the second or fourth week, then their number decreases, and the threshold level remains for a long time. IgG-AT to EBNA are detected two to four months after the acute phase, and their production persists throughout life.

According to our data, with HA EBV in more than half of patients, "early" IgG-Abs are detected in the blood, while specific IgM-Abs are determined much less frequently, while the content of late IgG-Abs to EBNA varies depending on the stage of exacerbation and state of immunity.

It should be noted that a serological study in dynamics helps in assessing the state of the humoral response and the effectiveness of antiviral and immunocorrective therapy.

• DNA diagnostics of CA VEBI. Using the polymerase chain reaction (PCR) method, the determination of EBV DNA is carried out in various biological materials: saliva, blood serum, leukocytes and lymphocytes of peripheral blood. If necessary, a study is carried out in biopsy specimens of the liver, lymph nodes, intestinal mucosa, etc. The PCR diagnostic method, characterized by high sensitivity, has found application in many areas, for example, in forensics: in particular, in cases where it is necessary to identify minimal trace amounts of DNA .

The use of this method in clinical practice to detect one or another intracellular agent is often difficult due to its too high sensitivity, since it is not possible to distinguish healthy carriage (the minimum amount of infection) from the manifestations of an infectious process with active virus reproduction. Therefore, for clinical studies, a PCR method with a given, lower sensitivity is used. As our studies have shown, the use of the technique with a sensitivity of 10 copies per sample (1000 GE/ml in 1 ml of the sample) makes it possible to detect healthy carriers of EBV, while reducing the sensitivity of the method to 100 copies (10000 GE/ml in 1 ml of the sample) gives the ability to diagnose individuals with clinical and immunological signs of HA VEBI.

We observed patients with clinical and laboratory data (including the results of serological studies) characteristic of a viral infection, in whom, at the initial examination, the analysis for EBV DNA in saliva and blood cells was negative. It is important to note that in these cases it is impossible to exclude the replication of the virus in the gastrointestinal tract, bone marrow, skin, lymph nodes, etc. Only a repeated examination in dynamics can confirm or exclude the presence or absence of HA EBV.

Thus, in order to make a diagnosis of HA EBV, in addition to conducting a general clinical examination, it is necessary to study the immune status (antiviral immunity), DNA, diagnosis of infection in various materials over time, and serological studies (ELISA).

Treatment of chronic Epstein-Barr virus infection

Currently, there are no generally accepted treatment regimens for HA VEBI. However, modern ideas about the effect of EBV on the human body and data on the existing risk of developing serious, often fatal diseases show the need for therapy and dispensary observation in patients suffering from HA VEBI.

The literature data and the experience of our work allow us to give pathogenetically substantiated recommendations for the treatment of CA VEBI. In the complex treatment of this disease, the following drugs are used:

• , in some cases in combination with IFN inducers - (creation of an antiviral state of uninfected cells, suppression of virus reproduction, stimulation of natural killers, phagocytes);
• abnormal nucleotides (suppress the reproduction of the virus in the cell);
• immunoglobulins for intravenous administration (blockade of "free" viruses in the intercellular fluid, lymph and blood);
• analogs of thymic hormones (contribute to the functioning of the T-link, in addition, stimulates phagocytosis);
• glucocorticoids and cytostatics (reduce viral replication, inflammatory response and organ damage).

Other groups of drugs, as a rule, play a supporting role.

Prior to the start of treatment, it is desirable to examine the patient's family members for the isolation of viruses (with saliva) and the possibility of re-infection of the patient, if necessary, the suppression of viral replication is also carried out in family members.

• The volume of therapy for patients with chronic active EBV infection (HA EBV) may be different, depending on the duration of the disease, the severity of the condition and immune disorders. Treatment begins with the appointment of antioxidants and detoxification. In moderate and severe cases, it is desirable to carry out the initial stages of therapy in a hospital setting.

The drug of choice is interferon-alpha, in moderate cases prescribed as monotherapy. The domestic recombinant drug reaferon has proven itself well (in terms of biological activity and tolerability), while its cost is significantly lower than that of foreign analogues. Used doses of IFN-alpha vary depending on weight, age, tolerability of the drug. The minimum dose is 2 million units per day (1 million units twice a day intramuscularly), the first week daily, then three times a week for three to six months. Optimal doses - 4-6 million units (2-3 million units twice a day).

IFN-alpha, as a pro-inflammatory cytokine, can cause flu-like symptoms (fever, headaches, dizziness, myalgia, arthralgia, autonomic disorders - changes in blood pressure, heart rate, less often dyspepsia).

The severity of these symptoms depends on the dose and individual tolerability of the drug. These are transient symptoms (disappear after 2-5 days from the start of treatment), and some of them are controlled by the appointment of non-steroidal anti-inflammatory drugs. When treated with IFN-alpha preparations, reversible thrombocytopenia, neutropenia, skin reactions (itching, rashes of a diverse nature), and rarely alopecia, may occur. Long-term use of IFN-alpha in high doses can lead to immune dysfunction, clinically manifested by furunculosis, other pustular and viral skin lesions.

In moderate and severe cases, as well as with the ineffectiveness of IFN-alpha preparations, it is necessary to connect abnormal nucleodites - valacyclovir (Valtrex), ganciclovir (Cymeven) or famciclovir (Famvir) to the treatment.

The course of treatment with abnormal nucleotides should be at least 14 days, the first seven days, intravenous administration of the drug is desirable.

In cases of severe CA VEBI, immunoglobulin preparations for intravenous administration at a dose of 10–15 g are also included in the complex therapy. etc.) within one to two months with gradual withdrawal or transition to maintenance doses (twice a week).

Treatment of EBV infection should be carried out under the control of a clinical blood test (once every 7-14 days), biochemical analysis (once a month, more often if necessary), immunological studies - after one to two months.

• Treatment of patients with generalized EBV infection is carried out in a hospital, together with a neuropathologist.

First of all, systemic corticosteroids are connected to antiviral therapy with IFN-alpha and abnormal nucleotides in doses: parenterally (in terms of prednisolone) 120-180 mg per day, or 1.5-3 mg/kg, it is possible to use metipred 500 pulse therapy mg IV drip, or orally 60-100 mg per day. Plasma and/or immunoglobulin preparations for intravenous administration are administered intravenously. With severe intoxication, the introduction of detoxifying solutions, plasmapheresis, hemosorption, and the appointment of antioxidants are indicated. In severe cases, cytostatics are used: etoposide, cyclosporine (sandimmun or consupren).

• Treatment of patients with EBV infection complicated by HPS should be carried out in a hospital. If HPS is leading in the clinical picture and life prognosis, therapy begins with the appointment of large doses of corticosteroids (blockade of the production of pro-inflammatory cytokines and phagocytic activity), in the most severe cases with cytostatics (etoposide, cyclosporine) against the background of the use of abnormal nucleotides.
• Patients with latent erased EBV infection can be treated on an outpatient basis; therapy includes the appointment of interferon-alpha (alternation with IFN inducer drugs is possible). With insufficient efficiency, abnormal nucleotides are connected, immunoglobulin preparations for intravenous administration; based on the results of an immunological examination, immunocorrectors (T-activators) are prescribed. In cases of the so-called "carriage", or "asymptomatic latent infection" with the presence of a specific immune response to the reproduction of the virus, observation and laboratory control (clinical blood test, biochemistry, PCR diagnostics, immunological examination) are carried out after three to four months.

Treatment is prescribed when a clinic of EBV infection appears or when signs of VID develop.

Carrying out complex therapy with the inclusion of the above drugs makes it possible to achieve remission of the disease in some patients with a generalized form of the disease and with hemophagocytic syndrome. In patients with moderate manifestations of HA EBV and in cases of an erased course of the disease, the effectiveness of therapy is higher (70-80%), in addition to the clinical effect, it is often possible to achieve suppression of virus replication.

After the suppression of the virus multiplication and obtaining a clinical effect, it is important to prolong the remission. Conducting sanatorium-and-spa treatment is shown.

Patients should be informed about the importance of observing the regime of work and rest, good nutrition, limiting / stopping alcohol intake; in the presence of stressful situations, the help of a psychotherapist is needed. In addition, if necessary, supportive immunocorrective therapy is carried out.

Thus, the treatment of patients with chronic Epstein-Barr virus infection is complex, carried out under laboratory control and includes the use of interferon-alpha preparations, abnormal nucleotides, immunocorrectors, immunotropic replacement drugs, glucocorticoid hormones, and symptomatic agents.

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14. Sakai Y., Ohga S., Tonegawa Y. Interferon-alpha therapy for chronic active Epstein-Barr virus infection // Leuk. Res. 1997 Oct; 21(10): 941-50.
15. Yamashita S., Murakami C., Izumi Y. Severe chronic active Epstein-Barr virus infection accompanied by virus-associated hemophagocytic syndrome, cerebellar ataxia and encephalitis // Psychiatry Clin. neurosci. 1998. Aug; 52(4): 449-52.

I. K. Malashenkova, Candidate of Medical Sciences

N. A. Didkovsky,doctor of medical sciences, professor

J. Sh. Sarsania, Candidate of Medical Sciences

M. A. Zharova, E. N. Litvinenko, I. N. Shchepetkova, L. I. Chistova, O. V. Pichuzhkina

Research Institute of Physical and Chemical Medicine of the Ministry of Health of the Russian Federation

T. S. Guseva, O. V. Parshina

GUNII epidemiology and microbiology them. N. F. Gamalei RAMS, Moscow

Clinical illustration of a case of chronic active EBV infection with hemophagocytic syndrome

Patient I. L., 33 years old, turned to the laboratory of clinical immunology of the Research Institute of Physical Chemistry on March 20, 1997 with complaints of prolonged subfebrile condition, severe weakness, sweating, sore throat, dry cough, headaches, shortness of breath on movement, palpitations, sleep disturbances, emotional lability (increased irritability, touchiness, tearfulness), forgetfulness.

From the anamnesis: in the fall of 1996, after severe tonsillitis (accompanied by severe fever, intoxication, lymphadenopathy), the above complaints arose, an increase in ESR persisted for a long time, changes in the leukocyte count (monocytosis, leukocytosis), anemia was detected. Outpatient treatment (antibiotic therapy, sulfonamides, iron preparations, etc.) proved to be ineffective. The condition progressively worsened.

Upon admission: t of the body - 37.8 ° C, skin of high humidity, severe pallor of the skin and mucous membranes. Lymph nodes (submandibular, cervical, axillary) are enlarged up to 1-2 cm, dense elastic consistency, painful, not soldered to the surrounding tissues. The pharynx is hyperemic, edematous, pharyngitis phenomena, tonsils are enlarged, loose, moderately hyperemic, the tongue is coated with a white-gray coating, hyperemic. In the lungs, breathing with a hard tone, scattered dry rales on inspiration. Borders of the heart: the left one is enlarged by 0.5 cm to the left of the midclavicular line, heart sounds are preserved, a short systolic murmur over the apex, irregular rhythm, extrasystole (5-7 per minute), heart rate - 112 per minute, blood pressure - 115/70 mm Hg Art. The abdomen is swollen, moderately painful on palpation in the right hypochondrium and along the colon. According to the ultrasound of the abdominal organs, a slight increase in the size of the liver and, to a slightly greater extent, the spleen.

Of the laboratory tests, attention was drawn to normochromic anemia with a decrease in Hb to 80 g/l with anisocytosis, poikilocytosis, polychromatophilia of erythrocytes; reticulocytosis, normal serum iron content (18.6 µm/l), negative Coombs test. In addition, leukocytosis, thrombocytosis and monocytosis were observed with a large number of atypical mononuclear cells, and ESR acceleration. In biochemical blood tests, there was a moderate increase in transaminases, CPK. ECG: sinus rhythm, irregular, atrial and ventricular extrasystole, heart rate up to 120 per minute. The electrical axis of the heart is deviated to the left. Violation of intraventricular conduction. Decrease in voltage in standard leads, diffuse changes in the myocardium, in chest leads there were changes characteristic of myocardial hypoxia. The immune status was also significantly impaired - the content of immunoglobulin M (IgM) was increased and immunoglobulins A and G (IgA and IgG) were reduced, there was a predominance of the production of low-avid, that is, functionally defective antibodies, dysfunction of the T-link of immunity, an increase in the level of serum IFN, a decrease in the ability to to IFN production in response to many stimuli.

In the blood, titers of IgG antibodies to early and late viral antigens (VCA, EA EBV) were increased. During a virological study (in dynamics) by the polymerase chain reaction (PCR), EBV DNA was detected in peripheral blood leukocytes.

During this and subsequent hospitalizations, an in-depth rheumatological examination and oncological search were carried out, other somatic and infectious diseases were also excluded.

The patient was diagnosed with the following diagnoses: chronic active EBV infection, moderate hepatosplenomegaly, focal myocarditis, somatogenically conditioned persistent; virus-associated hemophagocytic syndrome. immunodeficiency state; chronic pharyngitis, bronchitis of mixed viral and bacterial etiology; , enteritis, intestinal flora dysbiosis.

Despite the conversation, the patient categorically refused the introduction of glucocorticoids and interferon-alpha preparations. Treatment was carried out, including antiviral therapy (Virolex intravenously for a week, with the transition to Zovirax 800 mg 5 times a day per os), immunocorrective therapy (thymogen according to the scheme, cycloferon 500 mg according to the scheme, immunofan according to the scheme), substitution therapy (octagam 2.5 g twice intravenously drip), detoxification measures (gemodez infusions, enterosorption), antioxidant therapy (tocoferrol, ascorbic acid), metabolic preparations (Essentiale, Riboxin), vitamin therapy (multivitamins with microelements) was prescribed.

After the treatment, the patient's temperature returned to normal, weakness, sweating decreased, and some indicators of the immune status improved. However, it was not possible to completely suppress the replication of the virus (EBV continued to be detected in leukocytes). Clinical remission did not last long - after a month and a half there was a second exacerbation. In the study, in addition to signs of activation of a viral infection, anemia, and acceleration of ESR, high titers of antibodies to Salmonella were detected. Outpatient treatment of the main and concomitant diseases was carried out. A severe exacerbation began in January 1998 after acute bronchitis and pharyngitis. According to laboratory studies, during this period there was an increase in anemia (up to 76 g/l) and an increase in the number of atypical mononuclear cells in the blood. An increase in hepatosplenomegaly was noted, Chlamidia Trachomatis, Staphylococcus aureus, Streptococcus were found in a throat swab, Ureaplasma Urealiticum was found in the urine, a significant increase in antibody titers to EBV, CMV, herpes simplex virus type 1 (HSV 1) was found in the blood. Thus, the number of concomitant infections increased in the patient, which also indicated an increase in immunity deficiency. Therapy with interferon inducers, replacement therapy with T-activators, antioxidants, metabolic agents, and long-term detoxification were carried out. A noticeable clinical and laboratory effect was achieved by June 1998, the patient was recommended to continue metabolic, antioxidant, immunoreplacement therapy (thymogen, etc.). When re-examined in the fall of 1998, EBV was not detected in saliva and lymphocytes, although moderate anemia and immune dysfunction persisted.

Thus, in patient I., 33 years old, acute EBV infection took on a chronic course, complicated by the development of hemophagocytic syndrome. Despite the fact that it was possible to achieve clinical remission, the patient needs dynamic monitoring in order to both control EBV replication and timely diagnosis of lymphoproliferative processes (given the high risk of their development).

Note!

• EBV was first isolated from Burkett's lymphoma cells 35 years ago.
• Epstein-Barr virus belongs to the herpesvirus family.
• Today, approximately 80-90% of the population is infected with EBV.
• Reproduction of EBV in the human body can cause aggravation (occurrence) of secondary immunodeficiency.

The high infection of the population with the Epstein-Barr virus is an important problem of modern medicine. Often the disease passes without visible symptoms and is characterized by an independent recovery of the body, which causes many people to take a frivolous attitude towards EBV. Children can become infected through toys contaminated with the saliva of the virus carrier. The disease is transmitted from the simultaneous use by sick and healthy people of household items, underwear or through a kiss. Infection in a latent form during a long stay in the human body leads to the extinction of immunity and causes a number of diseases, such as hepatitis, multiple sclerosis, herpetic skin lesions and many others. Chronic fatigue syndrome is typical for victims of EBV. When the body cannot cope with the infection on its own, modern drugs are prescribed that are designed to destroy microbes in the blood, relieve the symptoms of the infectious process.

Antiviral drug Acyclovir

In the complicated course of EBV disease, an antiviral drug is recommended. According to its chemical composition, it is considered an acyclic analogue of deoxyguanosine, a natural component of DNA, where the ring structure of sugar is replaced by an acyclic side chain. The antiviral agent has significant advantages, which include high selectivity and low toxicity. The appointment of Acyclovir in Epstein-Barr is justified by a decrease in the level of viral replication, an improvement in the prognosis of the disease. Due to the special structure of the virus, the drug in acute infectious mononucleosis does not have an effective effect. From its reception it is recommended to refuse pregnant, elderly and lactating. In therapy, Acyclovir can be used orally, by intravenous injection or as an ointment to the site of infection. Only freshly prepared solutions should be used.

The virucidal drug Isoprinosine

One of the effective medicines in the treatment of the Epstein virus is considered. It perfectly suppresses the synthesis of viral proteins of deoxyribonucleic acid. The main advantage of the drug is a successful combination of antiviral and immunomodulatory functions. The tool has passed clinical trials with honor to confirm its effectiveness in placebo-controlled trials. Isoprinosine can be safely taken from the first year of life, in addition, it provides the following results:

• Viral load reduction
• Reduction of the period of remission
• No risk of reinfection and complications
• Rapid development of reverse inflammatory processes
• High security profile
• Accelerated recovery of the healthy functioning of the body after illness.

The indicators indicate that the drug is a fairly effective tested drug, but also has its own side reactions in the form of headaches, dizziness, nausea, and drowsiness.

To destroy the Epstein virus, an etiotropic schedule is widely used in the form of such a program:

1. First stage: initial therapy with Isoprinosine, which lasts ten days. The drug inhibits the replication of viral proteins and stops the synthesis of the virus. It is recommended to take up to 100 mg per kg of body weight orally. The daily diet is four doses.
2. The second stage: maintenance therapy with repeated use of the drug.
3. The third stage: rehabilitation therapy using an extended schedule, in which cell membranes are stabilized. Conducted under medical supervision.

An effective and safe result is shown by the combination of the drug with recombinant Viferon. A more significant positive dynamics appears, serological markers of an infectious disease disappear. Patients with EBV require long-term reinforcing therapy with strict monitoring of clinical and laboratory indicators of the intensity of the infectious process. It is recommended to carry out 3 courses of action for 10 days with an interval of 10 days.

Highly effective drug Valtrex

An antiviral drug is used to suppress the reproduction of a virus in a cell. It counteracts the synthesis and development of viral DNA. The effectiveness of the use of Valtrex is reflected in the improvement of cellular and humoral immunity, it prevents the entry of autoaggressive antibodies into the body. The drug can be taken by a child from two years old, but the attending physician should prescribe the dose and course. Valtrex has practically no side effects, and if they appear, they pass easily and quickly. Once in the body, it is completely converted into Acyclovir, with which it has similar pharmacokinetic parameters. Valtrex is a fairly new drug that has not been fully studied, so it should be taken only on the advice of a specialist.

Viferon with VEB

As an immunocorrective therapy for moderate and severe forms, it is recommended to take Viferon. As a result of medical studies, the following clinical effects have been identified:

• Antiviral function
• Reduction of terms of disappearance of intoxication
• Restoration of body activity
• Immunoreplacement and immunomodulating activity.

Side effects are not observed. Viferon can be taken in the complex therapy of EBV for children from the first days of life and newborns, as well as pregnant and lactating women under medical supervision. A contraindication is assigned to those who have intolerance to the composition of the drug.

Interferon-stimulating Cycloferon

A well-established drug studied in clinical areas, which is used in all forms of infectious mononucleosis caused by EBV. The effectiveness of the drug is caused by a wide range of biological actions:

• Antiproliferative
• Antiviral
• Antichlamydial
• Prevents the formation of tumor processes
• Immunomodulating.

The drug can be used by children over the age of 4 years. Before use, you should familiarize yourself with the content of contraindications and adverse reactions.

Acyclovir for children

The drug can easily be called the ancestor of antiviral drugs, which are still actively used. The popularity of Acyclovir is brought by the fact that it is sold without a prescription. This emphasizes its availability and safety. Acyclovir slows down the formation of viral DNA and helps in the fight against bacterial infection. The use of the drug for babies is quite advisable, but this should be done only with the permission of the attending physician, as there may be side effects. A plant immunomodulator is strictly forbidden to use if there are autoimmune diseases.

There are not many medicines that act on the infection. Most viruses are monitored by the immune system. The choice of the appropriate drug depends on the body's sensitivity to them, and children should not be given most over-the-counter medicines recommended by adults.

Epstein-Barr virus, or EBV, is included in the category of herpesviruses (herpes type 4). It is the most widespread viral infection, the danger of which was pointed out even by Einstein. According to the results of statistical studies, up to 60% of children and almost 100% of adults have encountered the presented virus.

What are the ways of transmission of the virus and the sources of infection

The Epstein-Barr virus in a child or adult will be transmitted primarily by airborne droplets (for example, when kissing). In addition, through the transmission of EBV, there may be common household items, which is a contact-household transmission route. We should not forget about the transmissible option - through the blood, as well as from the mother to her unborn child (vertical path). After all, this can also form a disease in a child.

The source of the presented viral infection can only be a person. In the vast majority of cases, we are talking about patients with a latent form or asymptomatic. The Epstein-Barr virus enters the human body through the upper respiratory tract. From there, it enters directly into the lymphoid tissue, causing various lesions. As a result of EBV, the lymph nodes, tonsils, liver area and spleen are affected - both in an adult and in a child. Before starting treatment, it is recommended to conduct a series of tests to confirm the disease so that the viral disease does not continue further.

Virus classification

There is no single classification of the Epstein-Barr virus (EBV). For application in the field of practical medicine in connection with the disease, the following gradation is offered:

• according to the time interval of infection, for example, congenital or acquired form, regardless of the causes;
• according to the form of the disease - typical (mononucleosis of an infectious type) and atypical: erased, asymptomatic, damage to internal organs;
• due to the characteristics of the course - mild, moderate or aggravated.

Epstein-Barr virus can be classified according to the duration of the course, the phase of activity, and the presence or absence of a complication.

It should not be forgotten that EBV in a child and an adult may refer to a mixed (mixed) infection. This kind of lesion in the vast majority of cases is identified in combination with cytomegalovirus infection. Before starting treatment and taking tests, it is strongly recommended to pay attention to the symptoms of the disease in an adult and a child. We invite you to familiarize yourself with what does genital herpes look like here.

Symptoms of a pathological condition in adults

Noting the signs of the Epstein-Barr virus, it is strongly recommended to pay attention to the four leading symptoms. The first of these is fatigue, followed by an increase in body temperature, as well as pain in the throat and changes in regional (most often cervical) lymph nodes. To check them, you will need certain tests.

Usually the disease begins with a feeling of holistic malaise. It can last at least seven days, after which the body temperature rises - up to 38-39 degrees. A change in the size of the lymph nodes up to two to three cm is identified.

It is noteworthy that as the Epstein-Barr virus develops, liver damage always begins - whether it is an adult or a child.

It may be associated with a feeling of heaviness in the right hypochondrium or darkening of the urine, speaking of Steinbar. In addition, a lesion of the spleen is diagnosed, which will increase in size.

The disease will last no longer than one to two weeks, after which a systematic recovery is planned. The change in the size of the lymph nodes and total weakness can persist for up to three weeks. The symptoms of EBV in a child deserve special attention.

Manifestations in children

Most often, children complain of a variety of disorders, the treatment of which can be difficult. In particular, it may be an increase in lymph nodes or, for example, mental disorders. Talking in more detail about the Epstein-Barr virus in a child, it is strongly recommended to pay attention to the fact that:

1. in a younger child, the encounter with the Epstein-Barr virus will be much stronger and more varied than in older children;
2. the particular threat of the disease presented is identified due to the unforeseen impact that may be inflicted;
3. EBV can provoke long-term processes in the kidneys and liver.

In a child, this can even be combined with symptoms of the chronic course of infectious mononucleosis. Temperature indicators are identified within 37.5 degrees (for many months). We should not forget that the symptoms may be accompanied by frequent fungal diseases, pathologies of the nervous and digestive systems. That is why the treatment of the Epstein-Barr virus is recommended to start as early as possible. Before this, you will need to pass certain tests to determine exactly how to treat the syndrome.

Diagnosis of the virus in adults and children

Diagnosis with suspected accession of acute or chronic infection of the Epstein-Barr virus can be made on the basis of complaints. Clinical manifestations and laboratory data obtained as a result of analyzes should also be taken into account. Only after that it will be possible to start treatment in a child and an adult.

Speaking directly about the diagnosis, pay attention to the implementation of a complete blood count and biochemical analysis in order to identify the antibody. In addition, the diagnosis that Einstein spoke of should include an immunological study, in which the state of the interferon system and even immunoglobulin is identified. Also, diagnostic tests should include serological tests and DNA testing. Only after this, the correct treatment of such a disease as EBV in an adult and a child can be carried out.

How is the treatment carried out

There is no specific treatment for Epstein-Barr virus. Therapy is carried out by an infectious disease doctor, subject to the addition of an acute or chronic pathology. A rehabilitation course can be carried out even by an oncologist, in particular in the formation of tumors and other neoplasms. All patients, especially those with infectious type EBV, should be hospitalized. Adults are strongly recommended a certain diet in the formation of hepatitis and, of course, absolute rest. It is necessary to pay attention to the fact that:

• as part of the treatment, it may be necessary to retake tests;
• actively use various categories of antiviral compounds, but it is important to use them only in connection with the recommendations of the attending physician;
• if necessary, antibiotic components are included in the treatment of adults for EBV disease.

Therapy can be carried out at the expense of tetracycline, cefazolin and other components. For example, this is necessary if the Epstein-Barr virus is combined with angina with extensive raids. In this case, treatment based on the results of the analyzes is carried out in a holistic course and ranges from seven to 10 days. This article is all about.

Features of therapy in children

In each child, therapy for the disease should be carried out differently than in adults. In particular, the use of intravenous immunoglobulin and complex vitamins is recommended. The child may be prescribed antiallergic drugs to deal with EBV in the early stages. Correction of symptoms and immunity is carried out through the appointment of immunomodulators, cytokines and even biological stimulants.

An important step in the recovery course should be considered the relief of a variety of symptoms of a pathological condition. Speaking of this, pay attention to the use of an antipyretic component with an increase in temperature indicators.

Tip: When a child coughs, formulations against this process, for example, Mukaltin, must be used without fail.

In addition, the treatment of Epstein-Barr virus with difficulty breathing through the nose should involve the use of drops.

Prognosis and complications of the Epstein-Barr virus

Complications in the presence of the Epstein-Barr virus may include the development of otitis media, peritonsillitis, and respiratory failure. We are talking about swelling in the tonsils and soft tissues of the oropharynx. Complications of EBV in a child or adult may include the development of hepatitis, rupture of the spleen, and hemolytic anemia.

In addition, if the disease has not been treated or analyzed for a long time, it can be aggravated by thrombocytopenic purpura, liver failure. It is highly recommended to pay attention to the following:

1. no less likely options for aggravating the condition can be considered pancreatitis and myocarditis;
2. the prognosis for Epstein-Barr virus, in general, can be assessed as favorable;
3. in other situations, it will depend on the severity and duration of the disease.

We should not forget about the likelihood of complications and the formation of various neoplasms. In this text, the most important thing in connection with what to do if formed herpes in men on the head.

FAQ

What diseases are caused by the Epstein-Barr virus?

The diseases associated with the Epstein-Barr virus are the following: infectious type mononucleosis, Hodgkin's disease (lymphogranulomatosis), polyadenopathy. We should not forget about the likelihood of developing chronic fatigue syndrome, malignant formations in the nasopharynx. Experts draw attention to the fact that the Epstein-Barr virus in a child and an adult can provoke lymphomas and even general immune deficiency. In order to avoid all this, it is strongly recommended to take all the required tests and carry out treatment on time.

What is the incubation period for Epstein-Barr disease?

The incubation period of the presented disease, on average, will be from 30 to 50 days. Depending on the characteristics of the patient's condition, fluctuations are likely in the range from four days to two months. Further, only the most necessary about herpes on the skin.

How long does the virus treatment take?

The duration of treatment is directly dependent on the severity of the course and the form (acute or chronic) of the disease. The recovery course of VEB can range from two to three weeks to several months.

According to statistics, about ninety percent of people meet with the Epstein-Barr virus. It happens that some even develop immunity to it, and they do not even suspect it. But, unfortunately, it is also possible that in some situations the disease in question has an extremely negative effect on the functioning of the organs of the human body, and direct acquaintance with it ends not with the standard development of immunity, but with extreme and severe complications that can even become a threat to life. So, in this article, the symptoms of the Epstein-Barr virus will be considered.

More about infectious mononucleosis

In the event that the disease passes in an acute form, then doctors can make a diagnosis such as "infectious mononucleosis". It is important to note that this pathogen enters the human body through the respiratory tract. Symptoms and treatment of the Epstein-Barr virus in children are of interest to many.

EBV begins the process of reproduction in B-lymphocytes directly in its cells, and already one week after infection, the first symptoms appear in patients, which are identical to acute respiratory disease.

What are the patients complaining about?

Thus, patients often present complaints such as:

During the examination of such a patient, the doctor will certainly note an enlarged spleen and liver, and laboratory tests of the patient's tests will reflect the occurrence of atypical mononuclear cells - these are young blood cells that have a general resemblance to both monocytes and lymphocytes. Epstein-Barr virus symptoms vary from person to person.

Is there a specific treatment?

There is no definitive and specific treatment for infectious mononucleosis. It has been scientifically proven that various antiviral drugs are absolutely ineffective, and any antibiotics are best used only in situations where a fungal and bacterial infection is attached. The patient should be in bed for a long time, gargle regularly, drink plenty of fluids and, of course, take antipyretic drugs. As practice shows, body temperature stabilizes already five to seven days after the onset of the disease, and enlarged lymph nodes return to their previous state in a month. It will take about six months for the blood counts to become normal.

It should be noted that if a person is faced with infectious mononucleosis, then certain antibodies will form in his body and remain for life, which are called class G immunoglobulins, and it is they who will ensure that the virus is completely ignored in the future.

Symptoms of the Epstein-Barr virus in a chronic form

In situations of complete lack of response from the human immune system, the infection can develop into a chronic condition. Doctors distinguish four types of these forms of EBV infection:

• Atypical. In this case, the patient experiences fairly frequent recurrences of infectious diseases of the intestines and urinary tract, and, in addition, acute respiratory ailments. The treatment of this pathology is very difficult, and its course is almost always very protracted.
• generalized infection. In such a situation, the nervous system falls under the impact of the virus, against which the development of encephalitis, meningitis, or radiculoneuritis can occur. The heart may also be affected, as there is a possibility of diagnosing myocarditis. The lungs are also at risk, because pneumonia can progress as a result of infection. The development of hepatitis is dangerous for the liver. Symptoms and treatment in adults with Epstein-Barr virus are often interrelated.

special instructions

It is important to pay attention to the fact that against the background of chronic EBV infection, doctors can also find the virus itself in the patient's saliva using the polymerase chain reaction method. You can detect and but the latter are formed only 3-4 months after the virus enters the body. Be that as it may, this will be absolutely insufficient to determine an accurate diagnosis. That is why immunologists and virologists conduct a survey of the total spectrum of antibodies.

What is the danger of the Epstein-Barr virus?

Above, there were cases of the Epstein-Barr virus (symptoms and treatment are considered) in a fairly mild form, and now let's try to figure out what the most dangerous and severe manifestations of this pathology are.

genital ulcers

Doctors diagnose this disease quite rarely and mainly among the female half of the population. The symptoms of genital ulcers that develop against the background of the Epstein-Barr virus include the following cases:

• lymph nodes in the armpits and inguinal region are noticeably enlarged;
• small ulcers form on the mucous membrane of the external sides of the genital organs;
• as the infection progresses, the sores can increase even more and become very painful, acquiring an erosive appearance;
• there is an increase in body temperature with the Epstein-Barr virus.

Symptoms and treatment in adults are closely related.

When does therapy fail?

It is noteworthy that genital ulcers within the framework of the virus in question are not subject to absolutely no treatment. Even a drug like Acyclovir, which can help with type 2 herpes, is ineffective in a particular situation. But, nevertheless, as practice shows, ulcers disappear on their own without recurrence.

It is important to pay attention to the fact that the main danger lies in the high risk of fusion of fungal and bacterial infections, since the ulcers themselves represent some kind of open gate. In this situation, it is necessary to undergo a course of antibacterial and antifungal therapy.

Oncological diseases against the background of the virus

Symptoms of the Epstein-Barr virus in adults may manifest themselves in the following.

There are a number of oncological diseases associated with it, the direct participation of which there are many scientifically proven facts. So, these diseases include:

• Hodgkin's disease or in other words lymphogranulomatosis. This ailment manifests itself through weakness, a sharp weight loss, dizziness and swollen lymph nodes in absolutely all places of the human body. Diagnosis in this case is carried out comprehensively, and only a biopsy of the lymph node can put the final point in this, during which, most likely, giant Hodgkin cells will be found in it. The treatment process consists in following the course of radiation therapy. According to statistics, remission can be observed in seventy percent of cases. What else can cause the Epstein-Barr virus? Symptoms and treatment are also given.
• Burkitt's lymphoma. This disease is diagnosed mainly among school-age children and only in African countries. The resulting tumor usually affects the kidneys, ovaries, lymph nodes, and adrenal glands. In addition, the lower or upper jaw is at risk. An effective and successful method of treatment does not currently exist. What else can be the symptoms of the Epstein-Barr virus?
• Lymphoproliferative disease. This type of disease is characterized by a general proliferation of lymphoid tissue, which is malignant in nature. This pathology manifests itself only through an increase in the lymph nodes, and the diagnosis can only be made after the biopsy method. Treatment is carried out according to the principle of chemotherapy. True, it is impossible to give any general predictions in this case, since everything directly depends on the individual characteristics of the course of the disease itself and the human body as a whole.
• Nasopharyngeal carcinoma. This tumor is malignant in nature and is usually located in the region of the nasopharynx, in its upper part. This cancer is most often diagnosed in African countries. Its symptoms are pain in the throat, hearing loss, persistent nosebleeds, prolonged and persistent headache.

What else is the symptomatology in children of the Epstein-Barr virus (there is a large number of photos).

Epstein-Barr virus autoimmune disease

Science has already proven that this virus is able to exert its influence on the immune system of the human body, as it causes the rejection of native cells, which soon leads to autoimmune diseases. Very often, the ailment under consideration provokes the occurrence of chronic glomerulonephritis, autoimmune hepatitis, rheumatoid arthritis and Sjögren's syndrome.

chronic fatigue

In addition to the above diseases, the appearance of which can provoke the Epstein-Barr virus, it is necessary to mention the syndrome of constant and chronic fatigue, which is quite often associated with herpes and occurs not only in the form of general weakness and fatigue, but also the presence of headaches, apathy and all kinds of disorders of psycho-emotional well-being. Quite often in this regard, relapses associated with acute respiratory diseases occur. In this way, mononucleosis is manifested, provoked by the Epstein-Barr virus (pictured).

Symptoms and treatment in children

To date, there is no general unified scheme in the treatment of pathology. Of course, in the arsenal of doctors and specialists there are all kinds of specific drugs, such as, for example, Cycloferon, Acyclovir, Polygam, Alphaglobin, Reaferon, Famciclovir and others. But the expediency in their appointment, as well as the duration of administration and dosage volume, should be determined solely by the attending physician after passing a complete examination of the patient, including laboratory. This is confirmed by the pediatrician Komarovsky.

Malignant formations that are associated with the Epstein-Barr virus cannot be attributed to the standard forms of mononucleosis. These are completely independent diseases, even though they are caused by the same pathogen. For example, Burkitt's lymphoma is characterized by the occurrence of tumors in the region of the intra-abdominal cavity.

Conclusion

Thus, it is obvious that it would be best if the treatment and diagnosis of the virus in adult patients is carried out before it can be activated. Otherwise, most likely, you will have to deal with the therapy of concomitant diseases.

We have considered the Epstein-Barr virus. Symptoms and treatment of children and adults are described.