How to Treat an Epstein Barr Infection. Epstein Barr - viral infection, symptoms, treatment. Treatment of infectious mononucleosis

The Epstein-Barr virus belongs to the herpesvirus family. Short name: VEB, HHV-4, EBV, HHV-4.

Virus Epstein - BARR (Epstein-Barr virus, Human Herpes Virus type 4). It was first described in 1964 and named after its authors, virologist Michael Anthony Epstein, and his graduate student Yvonne Barr from the UK. This virus is one of the most common viruses found in humans. He is credited with participating in the formation of tumor cells in the human body. Many people infected with the virus carry the disease with little or no symptoms. At the initial stage, the virus does not pose a particular threat, because it does not affect important organs, the circulatory system. But when complications occur, the virus can destroy brain cells.

Antibodies (Abs) to the Epstein-Barr virus (EBV) are found in 60% of children in the first two years of life and in 80-100% of adults.

Epstein-Barr virus is transmitted primarily through saliva, sometimes through blood transfusion, and is highly contagious (it is easy to get infected).

Diseases caused by the virus

Epstein-Barr virus causes diseases such as infectious mononucleosis and Burkitt's lymphoma. Burkitt's lymphoma is diagnosed among residents of African countries (Uganda, Nigeria, Guinea-Bissau). The disease affects mainly children aged 4-8 years. The tumor, the appearance of which provokes a virus, affects the lymph nodes, kidneys and adrenal glands, ovaries, lower or upper jaws.

Regarding infectious mononucleosis, which is also called the “kissing disease”, it infects, as a rule, children and young people. In developing countries, up to half of the child population, whose age does not exceed 5 years, are carriers of the virus received from their mothers. In developed countries, this rate of infection is typical for people over the age of 18.

You can become infected with the virus through saliva, objects, during a blood transfusion, with a handshake. After an incubation period, which can last up to 1 or 2 months, the virus multiplies rapidly. Moreover, this happens in the lymph nodes and cells of the membranes of the pharynx and nose.

Symptoms of the virus are manifested in chills, a sharp jump in temperature (up to 38 degrees and above). Infected patients note severe headache, pain during swallowing, excessive sweating. In general, the development of the virus is disguised as symptoms of acute respiratory infections, fever, tonsillitis or pharyngitis. More complete information on this issue can be found in the article “Epstein-Barr virus. Symptoms and treatment.

After getting into the blood after reproduction, the virus spreads throughout the body. Its particles begin to spread into the environment along with the secretions of the human body (saliva, cervical mucus). During the examination of a sick person, enlarged lymph nodes are found in different parts of the body. At the same time, they are painless and for this reason do not cause tangible discomfort to a person. The course of the disease ends with a change in the blood formula due to a decrease in the number and properties of white blood cells. The body usually fights the virus on its own, and improvement occurs after a few weeks (up to 2 months).

Varieties of the Epstein-Barr virus

This virus (abbreviated as EBV, EBV) infects B-lymphocytes in human blood. Depending on what disease provokes its reproduction, There are several antigens to the virus:

1. EBV-VCA (capsid antigen). Viral capsid antigens IgG and IgM provoke the production of antibodies to them only in the acute stage. IgM levels decrease after 1-3 months, but low IgG levels can persist throughout life. High levels of IgG viral capsid antigen are diagnosed with Burkitt's lymphoma, nasopharyngeal carcinoma, and immunosuppression. Positive titers of both antigen classes indicate an acute infection.
2. EBV-EA (early antigen). Antibodies to this antigen begin to be produced during the acute stage, however, an increase in their number occurs much more slowly. Their level decreases two months after infection with the virus. Perhaps their complete disappearance after a year.
3. EBV-EBNA. This is the core antigen of the virus. Antibodies to it are produced only a month after infection with the virus. They are characterized by high rates and can remain in the blood throughout a person's life as indicators of immunity.

Epstein-Barr virus symptoms

Many manifestations and symptoms of the Epstein-Barr virus are observed over time. A person feels weak, sometimes his sleep is disturbed, body temperature rises, lymph nodes increase. If these symptoms recur, we can confidently talk about the transition of the disease to a chronic form. The virus leads to chronic fatigue syndrome - a person constantly feels weakened, and even a ten-hour sleep does not restore strength. Vacation also does not give a person a feeling of relaxation and a surge of energy.

To accurately determine the presence of this virus in the body, it is not enough to know its main symptoms; modern diagnostic methods are needed, for example, an enzyme immunoassay. If 90% of the adult population are already carriers of the Epstein-Barr virus, then the number of adolescents is less - about 50%.

To detect the virus, a blood or saliva test is done. When confirming its presence in the body, it is quite difficult for doctors to determine at what stage the disease is. It is little studied, so all the work of physicians is aimed mainly at eliminating its symptoms. Medicines for the treatment of the disease in the chronic stage have not yet been developed. Immunomodulators are used, a special nutritious diet, physiotherapy, optimal physical activity are prescribed.

There are signs of a sore throat, sometimes a rash appears. In most cases, everything ends happily. A severe course occurs only with HIV infection and other severe immunodeficiencies. The Epstein-Barr virus has receptors that allow it to penetrate one of the types of human protective cells - B-lymphocytes. This allows it to stay in the body for a long time and get into almost all organs and tissues. But such a neighborhood is often bad for health, and immune cells begin to attack a person's own tissues. These diseases are called autoimmune diseases.

Examples are rheumatoid arthritis, systemic lupus erythematosus and others. In addition, B-cells can lose their normal structure, acquire the properties of tumor tissues and lead to malignant processes - lymphomas, lymphosarcomas, lymphogranulomatosis. Epstein-Barr virus is also considered responsible for the manifestations of chronic fatigue syndrome. Some doctors blame him for the occurrence of multiple sclerosis, causeless liver damage.

Treatment of Epstein-Barr virus infection

There is no specific treatment for Epstein-Barr virus. The patient is provided with peace, given a lot to drink, if necessary, antipyretic drugs are prescribed. In some cases, it is necessary to prescribe hormones, antiviral drugs, interferon. Infectious mononucleosis requires treatment of the patient in a hospital. To suppress the virus, a course of antibiotics, antihistamines and immunomodulators is prescribed. At its core, treatment is aimed at eliminating the symptoms of the disease. If the Epstein-Barr virus caused the development of a tumor, the patient is prescribed a course of anticancer drugs.

To diagnose the disease, you should be examined by an infectious disease specialist and a pediatrician (children). You will also need to take a blood test that will show the presence of antibodies. Additionally, an immunological examination may be prescribed.

Therapy for an infection caused by the Epstein-Barr virus is guided by several principles:

1. the use of a complex of drugs aimed at eliminating symptoms and treating developed diseases;
2. non-drug methods of treatment;
3. long-term and continuous treatment of a successive nature in a hospital, clinic and rehabilitation center;
4. drawing up an individual treatment program that takes into account the patient's age, stage of infection, immunological, clinical and other indicators.

It is far from always necessary to have treatment, since in children the infection is often hidden, the symptoms are blurred and it is not possible to clearly recognize the disease. In this case, they are limited to observation by the attending physician and use drugs that relieve inflammation and help remove toxins from the body. It would be appropriate to use traditional medicine to eliminate the symptoms of the disease.

Serious hospital treatment is required for chronic infections, as well as if there are complications on other organs.

However, the danger is caused by the Barr-Epstein virus (EBV), which plays a role in the formation of a tumor, and cytomegalovirus (CMV) poses a threat to the fetus of a pregnant woman.

Why is the EBV virus called that?

The English professor M. A. Epstein, whose surname in Russian sounds like Epstein, and in English - Epstein, in 1960 became interested in the report of the surgeon D. Burkitt. In it, the doctor described cancer, which is common among children living in a moderately humid hot climate.

Mike Anthony Epstein, along with his graduate student Yvonne Barr, worked on samples taken from a tumor until, in 1964, they discovered a previously unknown virion and designated it HHV-4. Later, herpes began to be called the Epstein Barr EBV virus in honor of the scientists who discovered the pathogen. Sometimes, due to a slight similarity between the names Einstein (Einstein) and Epstein, or a misreading of it, the name “Einstein virus” or “Einstein Barr virus” is found on the Internet.

Characteristics of VEB

The virion is the type species of the genus Lymphocryptovirus, belonging to the subfamily Gammaherpesvirinae. A distinctive feature of the Epstein virus from other herpes is its lymphotropism. That is, it prefers lymphocytes and cells of lymphatic tissue, but successfully multiplies in the blood, brain elements. The Epstein virus is primarily found in epithelial cells of the pharynx, nose, oral cavity, tonsils, adenoids, and salivary glands.

Herpes mainly affects children after a year and young people, and a person older than 35 years of age, as a rule, gets sick again with a relapse. If a woman overcame the Epstein Barr and Cytomegalovirus viruses before pregnancy and managed to acquire immunity, the presence of an antigen in the mother's body no longer poses a direct threat to the embryo.

The source of the spread of EBV becomes a carrier of herpes or a person who has previously had an infection. Once on the mucosa, the virion attaches to the epithelium, and eventually penetrates to the lymphocytes. The Epstein virus adheres with its shell to the cell and combines with it, causing the element to deform. The damaged lymphocyte turns into an atypical mononuclear cell and, during the initial infection, can hide in the system for a long time without causing signs of infection.

Infects the virus of another person by aerosol or contact mode of transmission. That is, by airborne droplets, with kisses, intercourse without a condom, together with donor biomaterial - blood, organ, bone marrow, during pregnancy, transplacental or during childbirth, if the child swallows cervical mucus. All types of herpes are transmitted in this way, including Epstein-Barr virus and cytomegalovirus.

With a weakened defense of the body or immunodeficiency, EBV begins intensive replication and during 2-60 days of the incubation period of the virus, the infection turns into one of the diseases accompanied by a mononucleosis-like syndrome. Treatment is carried out for a day or longer if a relapse occurs, or EBV provoked severe consequences.

Epstein Barr virus can cause the development of such a pathology:

• nasopharyngeal carcinoma;
• hepargin;
• Burkitt's lymphoma, other cancers belonging to this group;
• multiple sclerosis;
• tumors with localization in the salivary glands, tonsils, nasopharynx, gastrointestinal tract and other organs;
• undifferentiated cancer;
• hairy leukoplakia;
• viral hepatitis;
• Epstein Barr herpes;
• immune deficiency;
• infectious mononucleosis (glandular fever);
• syndromes: mononucleosis-like, post-transplant proliferative, chronic fatigue, others.

Virus infection or disease caused by EBV can result in the patient's death or adverse effects. For example: latent or chronic form of EBV, development of autoimmune systemic pathologies, hemolytic disorders, meningitis, myelitis, pneumonia. Epstein Barr virus (EBV) also affects the heart muscle, central nervous system, and kidneys.

Once having been ill with an infection caused by herpes, a person remains its carrier for life. With a decrease in immunity, reactivation of a pathogenic microbe is possible, since today physicians do not have the opportunity to completely destroy the DNA of the virus in the patient's tissues.

Symptoms of EBV infection

Initially, the HHV-4 virus is the causative agent of infectious mononucleosis. Its primary signs are an increase in the lymph nodes of all groups accessible by palpation, as well as in the spleen and liver, pain in the throat and upper abdomen. The culmination of the infection begins with a sharp jump in temperature up to 38–40 ° C, general intoxication, inflammation of the tonsils, fever, shortness of breath, purulent discharge from the nasopharynx, sometimes a rash or yellowness of the skin appears.

A sharp increase in internal organs can lead to rupture of the spleen membrane or death, which is why the Epstein-Barr virus is dangerous in mononucleosis.

If the treatment method is incorrectly chosen or the person has weak immunity, the disease can develop into a chronic form. In this case, EBV infection acquires an erased, recurrent, generalized, or atypical variant of the course. Chronic Epstein-Barr virus is always accompanied by symptoms such as cough, migraine, arthralgia, myalgia, fatigue, intense sweating, mental and sleep disorders, memory loss. A person always has enlarged lymph nodes, spleen, tonsils, liver.

VEB diagnostics

For early detection of the virus, it is recommended to conduct a clinical analysis of the biomaterial. Blood sampling is done on an empty stomach, when the patient last ate 8 hours ago. With PCR diagnostics (polymerase chain reaction), a nuclear, early and capsid antigen is detected in the blood serum even during the incubation of the virus.

In the prodromal period, more than 10% of atypical mononuclear cells, as well as IgG, IgM antibodies, are detected by serological testing - ELISA, ICLA. If the infection culminates, hemolytic changes are seen in the general blood test. The percentage of damaged lymphocytes and healthy cells indicates the stage of VEBI, and the results will be explained by the attending physician when deciphering the analysis.

PCR diagnostics - the determination of the Epstein-Barr virus in the patient's biological fluids also helps to determine the activity of the infectious process.

When examining a person with chronic EBV infection, such an indicator as IgG avidity is quite informative, reflecting the nature of the relationship between the antigen-antibody complex. This laboratory test allows you to determine the duration of the disease and the approximate timing of infection.

Pregnant women require complex diagnostics: examination for cytomegalovirus, Epstein-Barr virus, syphilis and a number of others. This approach allows you to suspect in time and prevent the negative consequences of microbial activity.

EBV therapy

If the Epstein virus provoked cancer or a tumor, the patient is placed in an oncology dispensary, and the oncologist, surgeon, and other specialists select the treatment together. In the case when VEBI caused serious complications or proceeds in a severe form, the patient is hospitalized in the infectious diseases department and the therapy appropriate to the clinical case is prescribed.

When bacteria (streptococci, staphylococci) are connected to EBV, non-penicillin antibiotics are prescribed. Cefazolin, Tetracycline, Sumamed showed effectiveness against the Epstein-Barr virus. Doctors may also prescribe IV immunoglobulins (Pentaglobin). If a viral infection is severe, the appointment of drugs with an antiviral effect is practiced. Currently, there is no reliable specific treatment, but the patient can take antiviral drugs (Acyclovir, Zovirax, Valtrex), interferon preparations or its inducers (Isoprinosine, Cycloferon, Arbidol).

A patient with VEBI should:

• treat the pharynx with antiseptics (furatsilin, chlorophyllipt, sage);
• bury the nose with vasoconstrictors;
• drink multivitamin complexes (Multivitamin, Alphabet);
• take antihistamines (Fenkarol, Tavegil).

For pathologies that provoke the Epstein virus, you need bed rest and a Pevzner diet No. 5, even if the doctor allowed you to undergo treatment at home. It is necessary to exclude black bread, fried, fatty, smoked, spicy and sour dishes, legumes, mushrooms from the diet. You need to drink more non-carbonated water, compotes cooked from dried fruits, fruit and vegetable and berry juices, decoctions from medicinal herbs and rose hips.

Conclusion

If the Epstein Barr virus is detected during the diagnosis, help the immune system cope with the infection on its own. To do this, it is recommended to seek the advice of a doctor and find out the methods of dealing with HHV-4, the prevention of reinfection. The specialist will select drugs that have the ability to inhibit viruses and bacilli in mixed forms of infection. The doctor will also recommend a date for a control blood donation for the presence of atypical mononuclear cells and how to live, or rather, prevent the return of the infection so that a relapse does not occur.

Epstein Barr - viral infection, symptoms, treatment

Epstein-Barr virus (EBV) is one of the members of the family of herpes infections. Its symptoms, treatment and causes in adults and children are also similar to cytomegalovirus (herpes no. 6). VEB itself is called herpes under number 4. In the human body, it can be stored dormant for years, but with a decrease in immunity, it is activated, causing acute infectious mononucleosis and later - the formation of carcinomas (tumors). How else does the Epstein bar virus manifest itself, how is it transmitted from a sick person to a healthy one, and how to treat the Epstein Barr virus?

The virus got its name in honor of researchers - professor and virologist Michael Epstein and his graduate student Yvona Barr.

Einstein bar virus has two important differences from other herpes infections:

• It does not cause the death of host cells, but on the contrary, it initiates their division, tissue growth. This is how tumors (neoplasms) are formed. In medicine, this process is called polyferation - pathological growth.
• It is stored not in the ganglia of the spinal cord, but inside immune cells - in some types of lymphocytes (without their destruction).

The Epstein-Barr virus is highly mutagenic. With a secondary manifestation of infection, it often does not give in to the action of antibodies developed earlier, at the first meeting.

Manifestations of the virus: inflammation and tumors

Epstein-Barr disease is acute like flu, cold, inflammation. Prolonged low-level inflammation initiates chronic fatigue syndrome and tumor growth. At the same time, for different continents, there are specific features of the course of inflammation and localization of tumor processes.

In the Chinese population, the virus often forms nasopharyngeal cancer. For the African continent - cancer of the upper jaw, ovaries and kidneys. For residents of Europe and America, acute manifestations of infection are more characteristic - high fever (up to 40º for 2-3 or 4 weeks), enlargement of the liver and spleen.

Epstein Barr virus: how is it transmitted

Epstein bar virus is the least studied herpetic infection. However, it is known that the ways of its transmission are diverse and extensive:

The source of infection through the air is people in the acute stage of the disease (those who cough, sneeze, blow their nose - that is, they deliver the virus into the surrounding space along with saliva and mucus from the nasopharynx). In the period of acute illness, the predominant method of infection is airborne.

After recovery (decrease in temperature and other symptoms of SARS), the infection is transmitted by contact (with kisses, handshakes, common utensils, during sex). EBV stays in the lymph and salivary glands for a long time. A person is able to easily transmit the virus through contact during the first 1.5 years after the disease. Over time, the likelihood of transmitting the virus decreases. However, studies confirm that 30% of people have the virus in their salivary glands for the rest of their lives. In the other 70%, the body suppresses a foreign infection, while the virus is not found in saliva or mucus, but is stored dormant in blood beta-lymphocytes.

If there is a virus in human blood ( virus carrier) it is able to be transmitted from mother to child through the placenta. In the same way, the virus is spread through blood transfusions.

What happens when you get infected

The Epstein-Barr virus enters the body through the mucous membranes of the nasopharynx, mouth, or respiratory organs. Through the mucosal layer, it descends into the lymphoid tissue, penetrates into beta-lymphocytes, and enters the human blood.

Note: the action of the virus in the body is twofold. Some of the infected cells die. The other part - starts to share. At the same time, different processes predominate in the acute and chronic stages (carriage).

In acute infection, the infected cells die. In chronic carriage, the process of cell division is initiated with the development of tumors (however, such a reaction is possible with weakened immunity, but if protective cells are sufficiently active, tumor growth does not occur).

The initial penetration of the virus is often asymptomatic. Epstein-Barr virus infection in children manifests visible symptoms only in 8-10% of cases. Less often, signs of a general disease are formed (5-15 days after infection). The presence of an acute reaction to infection indicates a low immunity, as well as the presence of various factors that reduce the protective reactions of the body.

Epstein Barr virus: symptoms, treatment

Acute infection with a virus or its activation with a decrease in immunity is difficult to distinguish from a cold, acute respiratory disease or SARS. Epstein Bar's symptoms are called infectious mononucleosis. This is a general group of symptoms that accompany a number of infections. By their presence, it is impossible to diagnose the type of disease accurately, one can only suspect the presence of an infection.

In addition to the signs of the usual acute respiratory infections, there may be symptoms of hepatitis, tonsillitis, and a rash. The manifestations of the rash increase when the virus is treated with penicillin antibiotics (such erroneous treatment is often prescribed for incorrect diagnosis, if instead of a diagnosis of EBV, a person is diagnosed with tonsillitis, acute respiratory infections). Epstein-Barr - a viral infection in children and adults, the treatment of viruses with antibiotics is ineffective and fraught with complications.

Epstein Barr infection symptoms

In the 19th century, this disease was called an unusual fever, in which the liver and lymph nodes increase, and the throat hurts. At the end of the 21st century, it received its own name - Epstein-Barr infectious mononucleosis or Epstein-Barr syndrome.

Signs of acute mononucleosis:

• Symptoms of acute respiratory infections - feeling unwell, fever, runny nose, enlarged lymph nodes.
• Symptoms of hepatitis: enlargement of the liver and spleen, pain in the left hypochondrium (due to an enlarged spleen), jaundice.
• Symptoms of angina: soreness and redness of the throat, enlarged cervical lymph nodes.
• Signs of general intoxication: weakness, sweating, soreness in muscles and joints.
• Symptoms of inflammation of the respiratory organs: difficulty breathing, coughing.
• Signs of damage to the central nervous system: headache and dizziness, depression, sleep disturbances, attention, memory.

Signs of a chronic virus carrier:

• Chronic fatigue syndrome, anemia.
• Frequent recurrences of various infections - bacterial, viral, fungal. Frequent respiratory infections, digestive problems, boils, rashes.
• Autoimmune diseases - rheumatoid arthritis (joint pain), lupus erythematosus (redness and rashes on the skin), Sjögren's syndrome (inflammation of the salivary and lacrimal glands).
• Oncology (tumors).

Against the background of a sluggish infection with the Epstein-Barr virus, a person often manifests other types of herpetic or bacterial infection. The disease acquires an extensive character, is characterized by the complexity of diagnosis and treatment. Therefore, the Einstein virus often occurs under the guise of other infectious chronic diseases with undulating manifestations - periodic exacerbations and remission stages.

Virus carrying: chronic infection

All types of herpesviruses settle in the human body for life. Infection is often asymptomatic. After the initial infection, the virus remains in the body until the end of life (stored in beta-lymphocytes). In this case, a person often does not know about the carriage.

The activity of the virus is controlled by antibodies produced by the immune system. Unable to multiply and express itself actively, the Epstein-Barr infection sleeps as long as the immune system functions normally.

EBV activation occurs with a significant weakening of protective reactions. The reasons for this weakening may be chronic poisoning (alcoholism, industrial emissions, agricultural herbicides), vaccinations, chemotherapy and radiation, tissue or organ transplants, other surgeries, prolonged stress. After activation, the virus spreads from lymphocytes to the mucous surfaces of hollow organs (nasopharynx, vagina, ureteral canals), from where it gets to other people and causes infection.

Medical fact: herpes-type viruses are found in at least 80% of people examined. Bar infection is present in the body of the majority of the adult population of the planet.

Epstein Barr: Diagnosis

Symptoms of Epstein Barr virus are similar to signs of infection cytomegalovirus(also herpetic infection under No. 6, which is manifested by prolonged acute respiratory infections). To distinguish the type of herpes, to name the exact virus-causative agent - is possible only after laboratory tests of blood, urine, saliva tests.

The Epstein Barr virus test includes several laboratory tests:

• Blood tests for Epstein Barr virus. This method is called ELISA (enzyme-linked immunosorbent assay) determines the presence and amount of antibodies to infection. In this case, primary antibodies of type M and secondary type G may be present in the blood. Immunoglobulins M are formed during the first interaction of the body with an infection or when it is activated from a dormant state. Immunoglobulins G are formed to control the virus in chronic carriage. The type and amount of immunoglobulins makes it possible to judge the primacy of infection and its duration (a large titer of G bodies is diagnosed with a recent infection).
• Examine saliva or other biological fluid of the body (mucus from the nasopharynx, discharge from the genitals). This examination is called PCR, it is aimed at detecting virus DNA in samples of liquid media. The PCR method is used to detect various types of herpes viruses. However, when diagnosing Epstein-Barr virus, this method shows low sensitivity - only 70%, in contrast to the sensitivity of detecting herpes types 1,2 and 3 - 90%. This is because the bara virus is not always present in biological fluids (even when infected). Since the PCR method does not give reliable results of the presence or absence of infection, it is used as a confirmation test. Epstein-Barr in saliva - says there is a virus. But it does not show when the infection occurred, and whether the inflammatory process is associated with the presence of the virus.

Epstein-Barr virus in children: symptoms, features

Epstein-Barr virus in a child with normal (average) immunity may not show painful symptoms. Therefore, infection with the virus in children of preschool and primary school age often occurs imperceptibly, without inflammation, fever and other signs of illness.

The Epstein-Barr virus in adolescents often causes a painful manifestation of infection - mononucleosis (fever, enlarged lymph nodes and spleen, sore throat). This is due to a lower protective reaction (the reason for the deterioration of immunity is hormonal changes).

Epstein-Barr disease in children has features:

• The incubation period of the disease is reduced - they reduce the days after the penetration of the virus into the mucous membranes of the mouth, nasopharynx.
• Recovery time is determined by the state of immunity. Protective reactions of a child often work better than an adult (they say addictions, a sedentary lifestyle). Therefore, children recover faster.

How to treat Epstein-Barr in children? Does treatment depend on the person's age?

Epstein-Barr virus in children: treatment of acute infection

Since EBV is the least studied virus, its treatment is also under research. For children, only those drugs are prescribed that have passed the stage of long-term testing with the identification of all side effects. Currently, there are no antiviral drugs for EBV that are recommended for the treatment of children of any age. Therefore, children's treatment begins with general maintenance therapy, and only in cases of urgent need (threat to the life of the child) are antiviral drugs used. How to treat the Epstein bar virus in the stage of acute infection or when chronic carriage is detected?

In an acute manifestation, the Epstein-Barr virus in a child is treated symptomatically. That is, when symptoms of sore throat appear, they rinse and treat the throat, when symptoms of hepatitis appear, drugs are prescribed to maintain the liver. Mandatory vitamin and mineral support of the body, with a long protracted course - immunostimulating drugs. Vaccination after suffering mononucleosis is postponed for at least 6 months.

Chronic carriage is not subject to treatment if it is not accompanied by frequent manifestations of other infections, inflammations. With frequent colds, measures are needed to strengthen the immune system - hardening procedures, outdoor walks, physical education, vitamin and mineral complexes.

Epstein-Barr virus: treatment with antiviral drugs

Specific treatment of the virus is prescribed when the body cannot cope with the infection on its own. How to treat Epstein bar virus? Several areas of treatment are used: counteracting the virus, supporting one's own immunity, stimulating it and creating conditions for the full course of protective reactions. Thus, the treatment of the Epstein-Barr virus uses the following groups of drugs:

• Immunostimulants and modulators based on interferon (a specific protein that is produced in the human body during the intervention of a virus). Interferon-alpha, IFN-alpha, reaferon.
• Drugs with substances that inhibit the reproduction of viruses inside cells. These are valaciclovir (Valtrex drug), famciclovir (Famvir drug), ganciclovir (Cymeven drug), foscarnet. The course of treatment is 14 days, with intravenous administration of drugs recommended for the first 7 days.

Important to know: The effectiveness of acyclovir and valaciclovir against Epstein-Barr virus is under investigation and has not been scientifically proven. Other drugs - ganciclovir, famvir - are also relatively new and insufficiently studied, they have a wide list of side effects (anemia, disorders of the central nervous system, heart, digestion). Therefore, if Epstein-Barr virus is suspected, treatment with antiviral drugs is not always possible due to side effects and contraindications.

When treating in hospitals, hormonal drugs are also prescribed:

• Corticosteroids - hormones that suppress inflammation (they do not act on the causative agent of the infection, they only block the inflammatory process). For example, prednisolone.
• Immunoglobulins - to support immunity (administered intravenously).
• Thymic hormones - to prevent infectious complications (thymalin, thymogen).

When low titers of the Epstein-Barr virus are detected, treatment can be restorative - vitamin s (as antioxidants) and drugs to reduce intoxication ( sorbents). This is supportive therapy. It is prescribed for any infections, diseases, diagnoses, including those with a positive analysis for the Epstein-Barr virus. Treatment with vitamins and sorbents is allowed for all categories of sick people.

How to cure Epstein Barr virus

Medical research is asking the question: Epstein-Barr virus - what is it - a dangerous infection or a calm neighbor? Is it worth it to fight the virus or take care of maintaining immunity? And how to cure the Epstein-Barr virus? Medical responses are mixed. And until a sufficiently effective cure for the virus is invented, one must rely on the body's immune response.

A person has all the necessary reactions to protect against infections. To protect against foreign microorganisms, you need good nutrition, limiting toxic substances, as well as positive emotions, lack of stress. Failure in the immune system and infection with the virus occurs when it is weakened. This becomes possible with chronic poisoning, long-term drug therapy, after vaccination.

The best treatment for a virus is to create healthy conditions for the body, cleanse it of toxins, provide it with good nutrition, and enable it to produce its own interferons against infection.

All information is provided for informational purposes only. And it is not a guide for self-treatment. If you feel unwell, consult a doctor.

Epstein-Barr virus treatment

Causes of the Epstein-Barr virus

Epstein-Barr virus infection (EBV infection) is a common herpesvirus disease, most often occurring in the form of infectious mononucleosis, but may be accompanied by other manifestations due to suppression of the immune system, is associated with a number of oncological (nasopharyngeal carcinoma), predominantly lymphoproliferative diseases (Burkitt's lymphoma ), as well as with autoimmune pathology.

Over the past 10 years, the infection of the population with EBV in the world has increased several times and ranges from 90 to 100%. EBV infection is the most common herpesvirus infection in Ukraine. Epidemiological studies have shown that before reaching adulthood, about 90% of people become infected with EBV.

EBV is a human B-lymphotropic virus with pronounced oncogenic properties and exhibits tropism for B- and T-lymphocytes. The virus contains specific antigens: capsid, nuclear, early, membrane. The time of appearance and the biological significance of these antigens are not the same. Knowledge of the timing of the appearance of various antigens and the detection of antibodies to them make it possible to diagnose one or another clinical variant of the course of EBV infection. The virus also shares antigens with other herpesviruses. It is sensitive to the action of diethyl ether.

The source of infection are patients, including those with an erased course. The virus is excreted with nasopharyngeal mucus, saliva. Isolation of EBV sometimes lasts 18 months from the onset of the disease. The mechanism of transmission of infection is airborne. Due to the absence of cough and runny nose, EBV is released not intensively, at a small distance from the patient, and therefore the cause of EBV lies in prolonged contact. Children often become infected with EBV through toys contaminated with the saliva of a sick child or virus carrier. In the spread of infection, the sharing of dishes and linen by sick and healthy people is important. Blood contact and sexual transmission of the infection are also possible. Cases of vertical transmission of EBV from mother to fetus have been described, suggesting that this virus may be the cause of intrauterine anomalies.

The first infection with the virus depends on social conditions. In developing countries or in socially unfavorable families, infection of children occurs mainly before 3 years of age. In developed countries, the maximum infection occurs at age. Most of the manifesting lesions in EBV infection are recorded in males. But the reactivation of the infection can occur at any age; it is promoted by factors of decrease in the general and local immunity.

Immunity in infectious mononucleosis is persistent, reinfection only leads to an increase in antibody titer. There are certain features of the response of the human body to EBV infection. So, in East and Central Africa, the development of Burkitt's lymphoma predominates, in some regions of East Asia - nasopharyngeal carcinoma. While this is an inexplicable fact. Morphologically, in the acute period of the disease, a biopsy of the lymph nodes determines the proliferation of reticular and lymphoid tissue with the formation of large mononuclear cells, circulatory disorders. At the same time, Kupffer cell hyperplasia is detected, and in some cases, focal and widespread necrosis. The same histological changes are noted in the tonsils and paratonsillar tissue. In the spleen, follicular hyperplasia, edema and infiltration of its capsule by mononuclear cells are found. In severe forms of the disease, bile pigment is deposited in the hepatocytes of the central zones of the lobules.

In the International Classification of Diseases, in various sections, the following nosological forms that EBV infection entails are distinguished:

• gammaherpesvirus infectious mononucleosis,
• immunodeficiency due to a hereditary defective response to EBV,
• Burkitt's lymphoma
• malignant nasopharyngeal tumor.

In general, many syndromes and diseases are now associated with EBV. In particular, there is reason to believe that VEEB has been proven to be associated with the development of Hodgkin's disease and some non-Hodgkin's lymphomas, chronic fatigue syndrome, Stevens-Johnson syndrome, multiple sclerosis, hairy leukoplakia of the tongue, and the like. To date, there is no generally accepted clinical classification of EBV infection.

There are primary (acute infectious process - infectious mononucleosis) and chronic EBV infection. The incubation period for infectious mononucleosis varies from 6 to 40 days. Sometimes the disease begins with a prodromal period lasting 2-3 days, during which moderate fatigue, subtle lethargy, and a slight decrease in appetite appear. In typical cases, the onset of the disease is acute, the body temperature rises to °C. Patients complain of moderate headache, nasal congestion, discomfort in the throat when swallowing, sweating.

With infectious mononucleosis, the level of intoxication is much less than does not happen with fever of another etiology. Already in the first 3-5 days, acute tonsillitis, enlarged lymph nodes, liver and spleen appear. Fever in infectious mononucleosis can be constant, remitting or irregular, sometimes undulating. The duration of the febrile period ranges from 4-5 days to 2-4 weeks or more.

Lymphadenopathy is the most stable manifestation of the disease. First of all, the cervical lymph nodes increase, especially those located along the posterior edge of the sternocleidomastoid muscle, at the angle of the lower jaw. The increase in these nodes is noticeable at a distance when turning the head to the side. Sometimes the lymph nodes look like a chain or a package and are often symmetrically located, their diameter can reach 1-3 cm. They are elastic, moderately sensitive to the touch, not soldered together, mobile, the skin above them is not changed. At the same time, axillary and inguinal lymph nodes can (not always) increase, less often - bronchopulmonary, mediastinal and mesenteric.

There is a certain difficulty in nasal breathing, the voice may change somewhat. Discharge from the nose in the acute period of the disease is almost absent, since infectious mononucleosis develops posterior rhinitis - the mucous membrane of the lower nasal concha, the entrance to the nasal part of the throat, is affected. Simultaneously with lymphadenopathy, symptoms of acute tonsillitis and pharyngitis appear. Changes on the tonsils can be catarrhal, follicular, lacunar, ulcerative-necrotic, sometimes with the formation of a pearly white or cream-colored plaque, and in some cases - soft fibrin films, which to a certain extent resemble diphtheria. Such raids can occasionally even spread beyond the tonsils, accompanied by an increase in fever or its increase after a previous decrease in body temperature. There are cases of infectious mononucleosis without signs of severe tonsillitis.

Enlargement of the liver and spleen is one of the constant symptoms of infectious mononucleosis. In most patients, an enlarged spleen is detected already from the first days of the disease, it is of a relatively soft consistency, reaches its maximum size on the 4-10th day of the disease. Normalization of its size occurs no earlier than the 2-3rd week of the disease, after normalization of the size of the liver. The liver also increases as much as possible on the 4-10th day of illness. In some cases, an increase in the liver may be accompanied by a slight violation of its function, moderate jaundice.

In 5-25% of patients with infectious mononucleosis, a rash develops, which can be spotted, maculopapular, urticaria (urticaria), hemorrhagic. The timing of the appearance of the rash is different, it lasts for 1-3 days and disappears without a trace. Often occurs in the case of the appointment of aminopenicillins (ampicillin, amoxicillin) and is an immunoallergic reaction.

The atypical course of infectious mononucleosis includes cases of the disease when only some typical symptoms appear (for example, polyadenitis) or the most pronounced signs that are not typical are exanthema, jaundice, symptoms of damage to the nervous system.

After primary EBV infection, persistence of the virus in the body is often detected. It may not be clinically manifested (asymptomatic carrier or latent EBV infection). However, reactivation of EBV infection is possible, which leads to the development of a chronically relapsing variant of the course with damage to the central nervous system, myocardium, kidneys, and various lymphoproliferative disorders.

Individuals with severe immune deficiency may develop a generalized course of EBV infection with damage to the central and peripheral nervous system in the form of meningitis, encephalitis, polyradiculoneuritis. Immunodeficiency due to a defective hereditary response (lymphoproliferative disease associated with the X chromosome, Duncan's disease, Partilo's syndrome) in boys is characterized by an inadequate response to EBV for certain mutations in the X chromosome.

The prognosis is poor due to the occurrence of severe hepatitis, acute bone marrow failure, fleeting non-Hodgkin's lymphomas. Burkitt's lymphoma is a very high-grade non-Hodgkin's lymphoma that develops from B-lymphocytes and tends to spread outside the lymphatic system (into the bone marrow, blood, spinal column). Burkitt's lymphoma can develop at any age, but it is most common in children and young adults, especially men. Often the tumor develops in patients with HIV infection. Lymphoma cells can accumulate in large numbers in the lymph nodes and organs of the abdominal cavity, which leads to their increase. They can pass into the small intestine, causing intestinal obstruction or bleeding. Sometimes there is swelling of the neck and jaw, which can be very painful. Without treatment, Burkitt's lymphoma progresses rapidly and leads to death.

Nasopharyngeal carcinoma is a tumor that develops in the upper part of the throat and differs significantly from other types of head and neck tumors in its development, causes, clinical course, and treatment tactics.

How to treat the Epstein-Barr virus?

Infectious mononucleosis usually does not require antiviral treatment. Acyclovir preparations in this case have no effect.

In severe cases, a short course of glucocorticosteroids is indicated, for example, prednisolone at a dose of 0.001 g / kg per day for 5-7 days. Hyposensitizing and symptomatic agents are recommended.

In the case of a secondary bacterial infection, antibacterial drugs are prescribed in age-appropriate doses, with the exception of aminopenicillins. Among the etiotropic agents for the treatment of chronic active EBV infection in the reactivation stage, acyclovir and ganciclovir are used. However, these drugs do not give an effect in the latent course of the disease.

Acyclovir is prescribed in the same way as for herpes zoster. Ganciclovir is administered intravenously at a dose of 0.005-0.015 g/kg 3 times a day for days. The course can be extended up to 21 days. The maintenance dose is 0.005 g/kg per day. The drug in this dose is administered for a long time to prevent recurrence of the disease. For maintenance therapy, ganciclovir tablets 1 g 3 times a day can be used.

Alfa interferon preparations are used in the treatment of chronic active EBV infection. Recombinant interferon is prescribed in doses of 1 million IU per 1 m 2 of body area. The frequency of administration of the drug is 2 times a day with an interval of 12 hours. Duration of treatment at a dose of 1-3 million IU 2 times a day for the first week, then 3 times a week for 3-6 months.

In the case of severe forms of EBV infection, immunoglobulin is used for intravenous administration in a single dose of 3-4 ml/kg of body weight per day (0.15-0.2 g/kg of body weight per day) from 1 to 5 injections per course of treatment. The course dose should not exceed 2 g per 1 kg of body weight.

Burkitt's lymphoma is highly sensitive to various types of cytosatics; they are administered intravenously at a dose of 0.03-0.04 g/kg once if the disease is diagnosed at an early stage. Effective is the treatment with cyclophosphamide, which is twice with an interval of days. If the process spreads to the membranes and substance of the spinal cord and brain, methotrexate is administered intralumbally at a dose of 0.005 g, followed by its increase.

What diseases can be associated

Complications of infectious mononucleosis are varied and include:

Chronic EBV infection is more often complicated in immunocompromised individuals by diseases such as:

In general, in infectious mononucleosis, the prognosis is more favorable than in other forms of EBV infection, and only in a chronic course is it unfavorable.

Epstein-Barr virus treatment at home

Therapeutic measures for diseases provoked by EBV infection are carried out in a medical hospital, however, therapy does not differ in short-term therapy, and therefore some medications are also allowed at home.

Self-treatment of the disease is unacceptable, the maximum effect is achieved only in cooperation with competent specialists.

What drugs to treat the Epstein-Barr virus?

• Alfainterferon - at the rate of IU per 1 m 2 of body area, the frequency of administration twice a day with an interval of 12 hours; duration of treatment at a dose of 1-3 million IU twice a day for the first week, then 3 times a week for 3-6 months;
• Ganciclovir - 0.005-0.015 g / kg 3 times a day for days, and sometimes for 21 days; the maintenance dose is 0.005 g / kg per day for a long period;
• Immunoglobulin - in a single dose of 3-4 ml / kg of body weight per day, from 1 to 5 injections per course of treatment;
• Prednisolone - 0.001 g / kg per day for 5-7 days.

Treatment of the Epstein-Barr virus with folk methods

Infectious mononucleosis is a complex disease, the full treatment of which is possible only through the use of pharmaceuticals and traditional medicine methods. Folk remedies do not have sufficient potential to destroy the virus that has entered the body.

Epstein-Barr virus treatment during pregnancy

At the stage of pregnancy planning, expectant parents are advised to be screened for the presence of antibodies to the Epstein-Barr virus in their blood. The presence of antibodies is assessed positively, and the presence of the infection itself requires further clarification of its state - passive or active.

The active course of the disease at the stage of pregnancy affects the process very negatively. In most cases, expectant mothers with such an ailment are placed in a hospital until complete recovery. The optimal and safest treatment for the fetus for the mother is carried out after consulting the attending physician and passing specialized tests. Treatment of the Epstein-Barr virus is carried out only with the use of special modern preparations that contain interferon-alpha substances, abnormal nucleotides and various cytostatics. Immunoglobulins are also administered intravenously and corticosteroid hormones are used.

If EBV disease is passive, there is no need for any specific therapy.

The duration of such treatment is from two to three weeks. If the disease proceeds in a rather severe form, then the introduction of various immunoglobulins intravenously is also added to the main course of treatment.

Which doctors to contact if you have Epstein-Barr virus

Diagnosis is based on a combination of anamnestic, clinical and laboratory data. Clinical include:

• intoxication syndrome with fever,
• acute tonsillitis,
• swollen lymph nodes,
• difficulty in nasal breathing
• enlargement of the liver and spleen.

In the general analysis of the blood of patients with infectious mononucleosis, the changes are quite characteristic. Leukopenia, which may appear in the first 2 days of illness, is replaced by leukocytosis with a significant increase in the number of mononuclear cells - lymphocytes, monocytes. The level of segmented neutrophils decreases, while the number of stab neutrophils even slightly increases. ESR increases slightly. A characteristic feature is the presence of atypical mononuclear cells - mature mononuclear cells that have a large spongy nucleus, asymmetrically located in the cell. The cell protoplasm is wide and contains delicate azurophilic granularity. A belt of enlightenment often appears between the nucleus and the cytoplasm. The number of atypical mononuclear cells can reach 20% of all leukocytes or more. They appear on the 2-3rd day of illness and are observed in the blood for 3-4 weeks, sometimes up to 2 months or more.

With liver damage, the activity of ALT and AST, the level of bilirubin moderately increase.

The polymorphism of clinical manifestations, as well as the involvement of the immune system in the pathological process, necessitate specific confirmation of the diagnosis. Detection in blood serum of heterophilic antibodies to erythrocytes of various animals (sheep, bull, horse, etc.) in infectious mononucleosis is now practically not used due to certain technical problems and relative non-specificity. The method of choice is ELISA, which allows to detect antibodies of different classes. PCR is also actively used.

Symptoms and treatment of Epstein-Barr infection - how to recognize the disease?

The Epstein-Barr virus disease is fairly new and not fully understood. But it is already possible to recognize and stop the disease. What symptoms indicate the presence of a virus in the body, how to treat the disease, and what threatens an untreated disease to a person? These and other questions, read below in the article.

A little about the disease

In 1965, Canadian biologists Michael Epstein and Yvonne Barr conducted a study of tumor samples that were provided to them by the famous surgeon Denis Burkitt (who discovered a specific oncological pathology - Burkitt's lymphoma). As a result of a scientific study, scientists identified a microscopic infectious agent from the family of gamma-herpeviruses, which was later named in honor of its discoverers - the Epstein-Barr virus.

About the Epstein-Barr virus on video

This pathogen is considered the most common bacterium that can infect the human body - about 60% of the world's population are carriers of this virus.

• Filatov's disease (infectious mononucleosis) and Hodgkin's disease (lymphogranulomatosis);
• malignant neoplasms of the nasopharynx;
• lymphoma;
• general immune deficiency;
• shingles;
• tumors of the digestive system;
• "Hairy" leukoplakia of the oral cavity.

Helping patients in solving problems with ailments is carried out by specialists from several fields of medicine - infectious disease specialists, hematologists, pediatricians, therapists and oncologists. For a favorable outcome of the consequences of the stay of the pathogen, it is important to detect its presence in the body as early as possible and prevent its spread to others.

How can you get the Epstein-Barr virus?

The disease is not classified as a contagious infection such as influenza or chicken pox, the source of infection is a carrier of the virus or a sick person.

• by airborne droplets - when sneezing, coughing, talking, a virus is released into the external environment with nasopharyngeal mucus and saliva;
• with close and close contact - through dishes, toys, towels, with a kiss;
• during the transfusion of infected donor blood and its preparations;
• in utero (the baby becomes infected from an infected mother).

Despite such various ways of infection, many become infected from virus carriers without showing symptoms of the disease, but with the development of a stable immune defense against the virus. That is why there is an “immune layer” among the population - up to 40% of children and 80% of adults have lifelong antibodies to the infectious agent.

Causes of infection

The mucous membranes of the nasopharynx are the "entrance gates" of the pathogen, here the virus multiplies and the formation of the primary focus of infection occurs - nasal breathing becomes difficult, symptoms of catarrhal angina may appear. The state of the body's immune defense, the presence of concomitant diseases of the oropharynx and the degree of pathogenicity of the virus affect the outcome of the primary infection and lead either to the destruction of the virus "at the entrance gate" or to the development of an infection in an asymptomatic or clinically detectable form.

• recovery;
• transition to a chronic form of infection;
• asymptomatic virus - carriage;
• autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, Sjögren's disease);
• oncological pathology.

Epstein-Barr virus symptoms and signs

The incubation period lasts about three weeks - the virus is in a "dormant" state.

• fever
• the appearance of a herpetic rash;
• sore throat when swallowing;
• inflammation of the lymph nodes;
• pain in the heart and kidneys;
• disorders of the digestive tract;
• sleep disturbance;
• constant fatigue.

Carriers of the virus often suffer from fungal diseases; against the background of this pathogen, infection with other viral infections can also occur.

What diseases are caused by EBVI?

Most often, the Epstein-Barr virus is associated with infectious mononucleosis (glandular fever), which manifests itself:

In blood tests, the concentration of lymphocytes and liver enzymes - GGT, AsAT and ALT - increases, virocytes (atypical mononuclear cells) appear. The disease responds well to specific treatment, after three weeks all symptoms are weakened and the disease recedes.

The virus is known for its insidiousness - with untimely treatment, the disease weakens the patient's immunity and turns into a chronic EBV infection, which is characterized by:

• hemophagocytic syndrome;
• hepatitis;
• multiple sclerosis;
• catarrhal angina;
• pneumonia;
• exanthema;
• lymphogranulomatosis - an oncological disease of the lymphatic system;
• bacterial infections of the digestive and respiratory organs;
• fungal infections of the skin and mucous membranes.

• naso-pharyngeal carcinoma - a tumor that affects the nasopharynx;
• Burkitt's lymphoma - damage to the ovaries, kidneys, retroperitoneal lymph nodes, jaws occurs;
• leukoplakia of the mucous membranes - on the mucous membranes of the oral cavity, genital organs appear bleeding areas with a whitish coating.

In immunocompromised patients (cancer patients, carriers of HIV infection), the virus can cause severe pathologies of internal organs, damage to the spinal cord and brain.

How to treat the Epstein-Barr virus?

If you suspect that a virus has entered the patient's body, an experienced specialist will recommend that you undergo the necessary examinations:

1. Clinical and biochemical blood tests.
2. ELISA (serological test for antibodies to the virus).
3. PCR study (detection of pathogen DNA).
4. Heterophilic test (performed to detect a heterogeneous group of antibodies - product B - lymphoid proliferation caused by the virus).
5. Immunogram - for an accurate picture of the state of the immune system.
6. Ultrasound of the liver and spleen.

When infection is confirmed, treatment should be carried out without delay - this will not only improve the general condition of the patient, but also prevent many complications. Specific complex therapy should be carried out in a medical institution, under the supervision of qualified specialists.

1. Antibacterial and antiviral drugs - Isoprinazine, Acyclovir, Valtrex, Viferon (the doctor prescribes the drug, dose and duration of the course).
2. Hepatoprotectors - Karsil, Heptral, Essentiale.
3. Enterosorbents - Enterosgel, Smecta, White coal.
4. Antihistamines - Erius, Zirtek, Claritin.
5. Probiotics - Bifiform, Probiform.
6. Immunomodulators - Timogen, Immunorix, Ribomunil.
7. Diet therapy is a complete diet that is gentle on the digestive tract.
8. Soothing and strengthening folk remedies - decoctions of chamomile, mint, ginseng, oak bark.

After treatment, the patient is registered at the dispensary for at least six months. Consultations and examinations are carried out every month, laboratory tests - quarterly.

Disease prevention

Unfortunately, there is no specific prevention - vaccination for this type of virus.

That is why all preventive measures are aimed at:

• strengthening immunity;
• hardening of the body;
• compliance with the rules of personal hygiene;
• forethought when sick people appear in the team and close circle.

It is very important to lead a mobile lifestyle, take vitamins and cultivate resistance to stressful situations.

The Epstein-Barr virus is a member of the 4th group of herpes viruses. This species affects T- and B-lymphocytes. The causative agent is in the cells for a long time, as a result of which chronic infectious processes, oncological pathologies, and autoimmune processes develop. In the presence of the Epstein-Barr virus, the symptoms can be varied, and therefore the purpose of therapy also differs. Symptoms depend on the form of the virus. The most common are infectious mononucleosis and chronic fatigue syndrome.

In this article you will learn:

Acute infection

The incubation period for infectious mononucleosis (IVIE) can vary from one day to two months. The onset of the disease is slow, in the prodromal period, weakness, malaise may develop, body temperature may be normal or slightly elevated. A few days later, the temperature rises to 40 degrees. A person feels very bad, intoxication of the body occurs.

The virus multiplies in the cells of the salivary glands, lymph nodes and tonsils.

Therefore, the main specific symptoms of Epstein-Barr are polyadenopathy, that is, an increase in lymph nodes of all groups (mainly cervical, axillary, inguinal and femoral).

Their sizes can increase up to 2 cm, not very painful, not soldered together. The spleen, an organ made up of lymphoid tissue, is also enlarged (splenomegaly). After two weeks of illness, the size of the lymph nodes becomes the same. Another link in the immune system, the tonsils, are also amenable to the pathological process. They cause signs of sore throat, nasality, purulent discharge is possible.

Hepatomegaly (enlargement of the liver) can occur in rare cases, accompanied by a mild form of jaundice. In the acute period of infectious mononucleosis, the nervous system is often also involved. Inflammation of the brain develops - serous meningitis, meningoencephalitis, polyradiculoneuritis, encephalomyelitis.

With the normal course of the disease, it ends with the complete disappearance of the pathology.

The rash, which persists for about 15 days, can be of different types: spotted, papular, roseolous, punctate, and with hemorrhages.

Chronic form

In the chronic form, they differ in duration and relapses. The patient has a lot of mental disorders: depression, emotional instability, a decrease in the level of intelligence, memory and attentiveness, sleep disturbances.

Common symptoms: excessive sweating, weakness, muscle and joint pain, cough, nasal breathing disorder.

Immunity is practically destroyed, because the virus affects lymphocytes and other protective factors.

Polyadenopathy is also characteristic, the lymph nodes of the kidney, enlargement of the spleen, pain in the liver, hypertrophic processes in the tonsils are included in the process. Kidney nodes that are amenable to pathology cause a violation of the function of excreting harmful substances from the body along with urine. As a result, intoxication of the body occurs.

These symptoms do not disappear a few days after the onset, the process lasts for a long time, and sometimes even for years.

Due to a decrease in the level of immunity, a secondary pathological microflora joins, which causes herpes, lichen, inflammatory processes throughout the body, the appearance of complications and pathologies of internal organs.

chronic fatigue syndrome

The course of a chronic process can also lead to the appearance of signs of a disorder such as chronic fatigue. This form of the course of the disease can manifest itself from several weeks to several months.

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Due to the long-term presence of the virus in human blood, symptoms appear:

• Fatigue, weakness, apathy, even if the person did not do anything. Rest, long holidays do not help to get rid of this feeling;
• Aches in the body, in muscles and joints, flu symptoms: headache, fever to subfebrile levels, nasal congestion and sore throat;
• In the presence of fatigue, a person suffers from insomnia, sleep is disturbing with terrible dreams;
• Violations of mental status, the appearance of depression, apathy, psychosis, labile emotionality and behavior;
• Deterioration of memory, attentiveness.

Such symptoms appear because the brain is always in an excited state, it cannot rest, and the tension of the nervous system is not unloaded.

What diseases are caused by the Epstein-Barr virus?

There are diseases that are associated with EBV. Since the virus is in the cells of the body throughout life, with a decrease in the level of immune protection, it can manifest itself as the occurrence of various symptoms and pathologies during the period of exacerbation.

Very often, the process is accompanied by the development of tumors, that is, oncopathology. Most often in connection with the virus there are lymphomas of the central nervous system, Burkitt.

In addition, there are carcinomas of the nasopharynx, Kaposi's sarcoma, which is also associated with AIDS. The reason for the occurrence of neoplasms is a violation of the development and differentiation of B-lymphocytes. After all, the first targets of the virus are T- and B-lymphocytes. A few months after infection, autoimmune processes may also occur. For example, lupus erythematosus, Sjögren's syndrome.

The main diseases that are provoked by the Epstein-Barr virus:

There are many other diseases, the provoking factor of which is the presence of the Epstein-Barr virus and the weakening of the level of immune defense.

Why is the Epstein-Barr virus dangerous?

Like any other viral infection, the Epstein-Barr virus can cause serious consequences and complications. Due to the influence on the immune system, the functions of all internal organs are disrupted. That is, an infection can cause complications from any system of the body. These are mainly otitis media, paratonsillitis, hepatitis and hypertrophy of the spleen, anemia, inflammation of the pancreas, heart muscle, insufficiency of the function of some organs.

With an acute course of infection, the prognosis of the disease is more favorable. If drug therapy was not carried out, the symptoms were ignored, the virus was in the body for a long time and the process turned into a chronic form. The risk of complications, the formation of neoplasms and the development of autoimmune processes depend on this.

Epstein-Barr virus (EBV) or human herpesvirus type 4 is very common in the human population. According to statistics, 90% of people are its carriers. Primary infection most often occurs during childhood, usually around one year of age. In healthy children with normal immunity, the disease is asymptomatic or with mild manifestations resembling a cold.

The Epstein-Barr jgg virus poses a serious danger to children and adults with weakened immune systems, as it contributes to the formation of tumor cells in the body. Due to the fact that the disease is a frequent companion of immunodeficiency states, some of its manifestations are considered early symptoms of AIDS.

It is widespread everywhere, and outbreaks of the disease are periodically recorded, mainly among representatives of the adolescent group. In the older age category, infection with the virus is practically not registered (except for HIV-infected people).

The main danger of EBV is that once it enters the body, it remains in it for life and provokes the occurrence of many autoimmune and lymphoproliferative diseases.

Ways of infection

1. contact household,
2. fecal-oral,
3. airborne,
4. transfusion

For example, a child can become infected through toys on which the saliva of the carrier of the infection remains or if personal hygiene is violated.

In adults, the virus is transmitted through kissing, talking, coughing, sneezing an infected person nearby. The transfusion route of transmission of the infection, that is, through the transfusion of infected blood or its components, is not excluded.

The entrance gate for infection is the mucous membrane of the nasopharynx and mouth, where the virus multiplies. The outcome of primary infection will depend on many factors - the state of immunity, the presence of concomitant diseases, as well as the virulence of the infectious agent. There are several options for primary infection:

1. With strong immune protection, the virus is sanitized (destroyed).
2. The disease proceeds in an asymptomatic (subclinical) form.
3. There is a manifestation of the disease (the infection manifests itself in an acute form).
4. A primary latent form develops, in which the virus multiplies, and there are no clinical symptoms.

Features of the structure of the virus

Epstein-Barr virus jgg belongs to the herpesvirus family, but its DNA is much more complex and contains more genetic information.

The capsid - the outer shell of the virus - is quite dense, and is covered with a large number of glycoproteins - substances that allow the virus to attach to the cell membrane and penetrate through it. Due to this feature, the Epstein-Barr virus has a high virulence, i.e. ability to infect.

Despite the apparent simplicity of the structure of the virus, it is a rather complex structure. In the center is single-stranded DNA, complex enough for a virus, it is surrounded by a polysaccharide structure called a capsid, and on top of the capsid is covered with another shell containing antigens that will allow the virus to invade.

What tests confirm the presence of the virus?

An analysis for the Epstein-Barr virus involves the detection, first of all, of viral antigens (VCA capsid antigen of the Epstein-Barr virus, core antigens), detection of antibodies to them.

With the advent of the PCR technique, it became possible to determine viral DNA. The causative agent is found in saliva and tissue biopsy of the salivary glands, with the development of malignant neoplasms - in their cells.

A positive result of the analysis for the virus is registered in the majority of those examined. According to statistical estimates, about 90% of healthy people are carriers of the Epstein-Barr virus, while they have never revealed symptoms of infectious mononucleosis.

In patients with HIV infection who have malignant neoplasms of the oral cavity, the virus is always detected. It belongs to the so-called opportunistic infections that affect patients with a significant weakening of the immune system.

Epstein-Barr virus jgg antigens are detected in the saliva, less often in the blood, and even more rarely in the bone marrow of patients. The most common way of infection is through kissing. Children often become infected with it from their mothers when the mother kisses the child, so infection no longer occurs in adulthood.

In more rare cases, infection with the virus can occur through blood transfusions or organ transplants. In the latter case, the virus is extremely dangerous, because after transplantation, the recipient is forced to take drugs that reduce immunity.

Symptoms

The acute form of the disease caused by the Epstein-Barr virus is infectious mononucleosis. The incubation period averages from 5 to 20 days. The symptoms of this disease are nonspecific, so the percentage of diagnostic errors is extremely high.

Mononucleosis is manifested by fever, manifestations of tonsillitis, enlarged lymph nodes, and a rash on the body. Sometimes this is accompanied by jaundice, digestive disorders, swelling of the face. The patient's condition in acute form of mononucleosis is quite severe.

The main sign of an acute infection is an increase in lymph nodes (cervical, submandibular, occipital, axillary, supraclavicular, femoral, inguinal). Their size can reach 2 cm, the consistency is testy to the touch, the nodes are not soldered to each other and the surrounding tissues, they are characterized by moderate or mild soreness.

At the same time, the skin over them remains unchanged. The maximum severity of this process is noted on the 5th-7th day from the onset of the disease, by the end of the 2nd week, the lymph nodes decrease.

At the same time, the patient feels weakness, malaise, complains of sore throat. At first, the body temperature rises slightly, but after a few days it rises sharply (up to 39 - 40 ° C) and is accompanied by an increase in the symptoms of intoxication of the body. The palatine tonsils are affected, the presence of pus on the back of the pharynx is noted, there is difficulty in nasal breathing, the voice becomes nasal.

A rash often appears on the skin in the form of papules or roseola. Late signs include enlargement of the spleen, liver, darkening of urine and slight yellowness of the skin. In rare cases, acute infection affects the nervous system, which is manifested by symptoms of meningoencephalitis, serous meningitis, but these processes end with complete regression of lesions.

When taking antibiotics, the symptoms of mononucleosis increase, the patient's condition worsens, the disease takes longer and is more severe. In healthy people, the disease goes away on its own within 2-3 weeks, even without treatment. There are no relapses.

Sometimes complications can develop, such as damage to the cranial nerves. This is greatly facilitated by improper treatment, therefore, before taking action, it is necessary to accurately diagnose the disease.

Chronic Epstein-Barr virus

When the infection becomes chronic, relapses of the disease occur periodically. The patient complains of high fatigue, decreased performance, increased sweating, impaired nasal breathing, joint and muscle pain.

Headaches regularly appear, pain in the right hypochondrium, sleep is disturbed, concentration of attention decreases, memory problems begin.

Mental disorders are not uncommon, expressed in high emotional lability, or in depressive states. Sometimes chronic forms of EBV are complicated by the addition of a fungal or bacterial infection, inflammatory diseases of the digestive tract, respiratory system, and an increase in the size of the liver and spleen.

Burkitt's lymphoma and other diseases caused by a virus

Burkitt's lymphoma is a malignant tumor that affects the lymph nodes surrounding the oral cavity. At one time, it was thanks to this pathology that the Epstein-Barr virus was discovered ( Epstein- barr virus). The disease manifests itself in children of primary school age with serious immune disorders, including those born with HIV infection. Lymphoma quickly leads to death.

The virus also causes other diseases - proliferative syndrome, from which children of HIV-infected mothers often die, hairy leukoplakia of the mouth - one of the early symptoms of HIV infection, and other malignant neoplasms. It should be emphasized that the virus is dangerous only in combination with immunodeficiency; in healthy people, its carriage is asymptomatic.

Diagnostics

With the development of mononucleosis, correct diagnosis is of great importance, since treatment with incorrectly selected drugs, such as antibiotics, can aggravate the course of the disease and lead to the development of complications. The clinical picture of the disease is nonspecific, so it is impossible to make a diagnosis without laboratory confirmation.

Serological testing is the determination of IgM to the virus in the blood. This class of immunoglobulins is responsible for the immediate response to the appearance of an antigen in the form of an acute inflammatory reaction. A high titer of these antibodies indicates that the infection with the virus has occurred recently, and immediately led to the development of mononucleosis. A decrease in IgM titer indicates the transition of inflammation to the chronic stage.

IgG to the Epstein-Barr virus are present in all healthy carriers. Their detection suggests that the virus has been present in the body for a long time, there is no acute inflammation caused by it, and stable non-sterile immunity has been formed to it.

Simply put, the presence of IgG indicates that the immune system keeps the virus in check, preventing it from causing disease. In malignant neoplasms, the titer of this type of immunoglobulin gradually decreases. In the last stages of mononucleosis, on the contrary, it increases.

Specific and non-specific antibodies to the Epstein-Barr virus are determined by the method of enzyme immunoassay. The same method allows you to identify the capsid and nuclear antigen of the virus. These methods are used in the diagnosis of infectious mononucleosis, as well as to evaluate the effectiveness of treatment for malignant neoplasms.

There are more modern methods for detecting a virus, which are called direct, since they directly identify the pathogen itself. This is a culture method and PCR.

Polymerase chain reaction (PCR) allows you to identify the viral genome in the test material. There are two main methods - qualitative and quantitative. Qualitative definition allows you to identify the presence or absence of the virus, which in most cases is not a valuable diagnostic criterion.

Quantification is the detection of viral load, which is necessary to monitor the effectiveness of treatment. As a rule, both of these methods are important in the diagnosis of malignant tumors.

The culture method is the cultivation of viral particles on a colony of human cells. Most often, these are nerve cells or tumor cells of patients with Burkett's lymphoma or leukemia.

The method is quite expensive, but it allows you to absolutely unambiguously identify the presence of the virus and determine the nature of the malignant neoplasm. The growth of a colony of viruses requires a rather long time, so this method is used to diagnose malignant tumors, as well as in the selection of donors for transplantation.

Treatment

Like all members of the herpesvirus family, it is impossible to completely eliminate the Epstein-Barr virus in children and adults. In healthy people, treatment is not required - the immune system suppresses the excessive activity of the virus, so a healthy lifestyle, proper nutrition and timely examinations by a doctor are enough to avoid manifestations of the disease.

There are no specific measures of therapy; after confirming the diagnosis, the patient should be observed by an infectious disease specialist or an oncologist (in the presence of neoplasms). The patient is prescribed:

1. antiviral drugs (Acyclovir, Valtrex),
2. vitamin complexes,
3. interferons,
4. antiallergic drugs (Zirtek, Claritin),
5. immunoglobulins (intravenously).

To maintain the functioning of the liver and digestive system, hepatoprotectors, enterosorbents, and probiotics are used.

Treatment of EBV infectious mononucleosis requires bed rest, symptomatic management of angina, and fever. Antiviral drugs are prescribed for adults with a significant deterioration in well-being, for children - without fail. The following drugs are used:

• Cycloferon,
• Arbidol,
• human immunoglobulin

The duration of treatment largely depends on the severity and form of the disease, the presence of concomitant pathologies. On average, the course of therapy takes from 2 weeks to several months. All patients with infectious mononucleosis are hospitalized in a hospital, where, in addition to drug therapy, the patient is prescribed rest and a special diet.

Watch the video where Malysheva talks in detail about the danger of the Epstein-Barr jgg virus, about its symptoms and treatment:

Epstein-Barr virus often masquerades as other diseases, and doctors lose valuable time trying to make a correct diagnosis. Anna Levadnaya (@doctor_annamama) - a new generation doctor, pediatrician, candidate of medical sciences and mother of two children - dedicated her new post on Instagram to this topic. "Letidor" gives its full version.

The number of patients who want to treat their children with the Epstein-Barr virus (hereinafter referred to as EBV) or who are trying to link all their problems with the carriage of EBV is off scale. So this post is about him!

Epstein-Barr virus: what is this virus

• EBV is a virus of the herpes family. As with herpes, it is enough to meet him once, as he remains in the body for life.
• More than 90-95% of all people on the planet are VEB carriers. But carriage of EBV does not require treatment.
• The virus enters the body in childhood (in most cases from 2 to 6 years) through saliva, blood or by contact (with kisses, through dishes, toys, underwear), penetrating the body through the oropharyngeal mucosa, then the virus lives in lymphoid tissue and saliva .

The very first encounter with the virus can be asymptomatic - under the guise of a common ARVI or manifests itself in the form of infectious mononucleosis.

Epstein-Barr virus: symptoms

• An increase in temperature (more than 38.5⁰C, sometimes poorly controlled, sometimes prolonged, up to several weeks), sometimes severe intoxication (malaise, chills, nausea, vomiting, headache).
• Snoring and difficulty in nasal breathing.

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The reason is an increase in adenoid tissue, so vasoconstrictor nasal drops will not help!

• Sore throat, tonsillitis: white-gray plaques on the tonsils, loose, bumpy, more often in the form of islets and stripes (you can read about how to distinguish viral from bacterial tonsillitis here).
• Painless enlargement of lymph nodes (usually cervical and occipital), liver, spleen.
• Swelling around the eyes, jaundice, sometimes a rash on the body or on the palate.

Epstein-Barr virus: additional diagnostics

Additional tests that can help make a diagnosis but are not needed if the clinical picture is obvious:

In a blood test: an increase in monocytes (more than 10%) with the appearance of atypical mononuclear cells, as well as leukocytes, lymphocytes, in a biochemical analysis - an increase in ALT, AST, alkaline phosphatase, bilirubin; decrease in neutrophils, platelets.

IgM to capsid a/g EBV they talk about an acute infection (the child first encountered the virus) and persist for 1-3 months.

On ultrasound there is an increase in the spleen, liver and lymph nodes of the mesentery of the intestine.

Test "for heterophile antibodies"- positive since the end of the second week of illness.

Methods that will not speak of an acute illness(can be determined after the illness throughout life):

• PCR virus in saliva and blood
• IgG to EBV

How to treat mononucleosis

In most cases, the prognosis for infectious mononucleosis is favorable, it resolves on its own, complications are rare. Treatment for infectious mononucleosis is reduced to alleviating the symptoms of the disease: rinse the nose, ventilate the room, give plenty of fluids, provide peace, pick up antipyretics, and so on.