STRICT LYMPHOTROPISM OF EPSTEIN-BARR-VIRUS DURING ACUTE INFECTIOUS-MONONUCLEOSIS IN NONIMMUNOCOMPROMISED INDIVIDUALS

Previous investigations of exfoliated oropharyngeal cells from individ uals suffering from infectious mononucleosis (IM) suggested that the o ropharyngeal epithelia are the primary target and also the site of lif e-long persistence of the Epstein-Barr virus (EBV). This concept was w idely accepted. However, the investigation of histological sections wi th more sensitive EBV detection techniques has drawn this concept into doubt since EBV proved to be constantly absent in normal epithelial c ells. To elucidate the discrepancy, throat washings and peripheral mon onuclear blood cells from 16 patients suffering from IM were investiga ted for EBV-DNA and EBV gene products employing highly sensitive in si tu hybridization, immunocytochemistry, and polymerase chain reaction. Although all patients exhibited latently infected B lymphocytes in per ipheral brood, samples of exfoliated oropharyngeal cells were constant ly EBV-negative with the exception of three cases. In these cases, the patients additionally suffered from purulent ulcerating tonsillitis, EBV-infected B cells, but no EBV-infected epithelial cells were detect able. These findings support the view that recirculating lymphocytes o f B-cell origin, but not epithelial cells are the initial target. of E BV during primary infection and that B cells also represent the site o f life-long viral persistence. (C) 1997 by The American Society of Hem atology.