IMMUNOREACTIVATION OF EPSTEIN-BARR-VIRUS DUE TO CYTOMEGALOVIRUS PRIMARY INFECTION

Serological diagnosis of herpes virus infections is hampered by concur rent expression of IgM for heterologous members of this virus family. To assess the frequency of such multiple diagnostic findings and to un derstand their etiology, we sought by using IgG, IgM, and IgG avidity test serodiagnoses for Epstein-Barr virus (EBV) among immunocompetent or immune-suppressed patients with well-documented cytomegalovirus (CM V) primary infection. Controls had primary infection by EBV or had acu te septic or severe respiratory infection. Among EBV-seropositive pati ents with CMV primary infection, a large proportion (13/56, 23%) showe d antibody profiles of EBV reactivation: seroconversion of VCA IgM and /or greater than or equal to fourfold rise of VCA IgG, together with h igh or intermediate avidity of VCA IgG. Most of the CMV patients with EBV serodiagnosis showed also diagnostic HHV-6 antibody rises. In cont rast to the frequently occurring CMV-induced EBV immunoreactivation, E BV primary infections did not appear to induce immunoreactivations of CMV (0/22). Only one (2%) CMV patient had a significant varicella zost er virus (VZV) antibody rise. The studies show that CMV is a particula rly active inducer of some, but not all, members of the herpes virus f amily and suggest that the in vivo interplay between CMV and EBV occur s unidirectionally. The high frequency of heterologous herpes virus im munoreactivations poses demands on laboratory diagnosis. J. Med. Virol . 56:186-191, 1998. (C) 1998 Wiley-Liss, Inc.