INTERFERON-ALPHA THERAPY FOR CHRONIC ACTIVE EPSTEIN-BARR-VIRUS INFECTION - POTENTIAL EFFECT ON THE DEVELOPMENT OF T-LYMPHOPROLIFERATIVE DISEASE

Purpose: A patient with aggressive chronic active Epstein-Barr virus ( CAEBV) infection is described whose disease activity subsided after in terferon (IFN)-alpha therapy. Patient and Methods: The patient had int ermittent fever, cytopenia, liver dysfunction, hepatosplenomegaly, abn ormal titers of EBV-associated antibodies, and positive EBV genomes. R esults: Despite repeated trials of the antiviral agents prednisolone a nd gamma-globulin, his condition deteriorated. The administration of I FN-alpha (1 x 10(5) U/kg subcutaneously 3 times per week) led to a dra matic clinical improvement. During the IFN-alpha therapy, the rearrang ement bands of T-cell antigen receptor genes disappeared assessed by S outhern blotting with a decrease in the number of activated T cells, a lthough the EBV-genome remained evident. Conclusions: These observatio ns suggest that IFN-alpha is useful in managing CAEBV, possibly restra ining the clonal development of T-lymphoproliferative disease (LPD) an d EBV-associated B-LPD, although it does not eradicate the proliferati on of EBV.