Coinfection of multiple strains of Epstein-Barr virus in immunocompetent normal individuals: reassessment of the viral carrier state

This study reassesses the occurrence of Epstein-Barr virus (EBV) diversity and coinfection versus dominance of a single viral strain within immunocomp etent normal carriers. Polymerase chain reaction analysis of several differ ent polymorphic loci of the EBV genome was performed on collections of peri pheral blood mononuclear cells and multiple lymphoid and epithelial tissues of the same individuals. Autopsy specimens from 15 individuals who died of causes unrelated to EBV infection served as normal viral carriers. Unexpec tedly, coinfection of multiple distinct strains of EBV of the same type (us ually type 1) and less frequently of both types 1 and 2 was found to be ver y high within individual viral carriers. These data indicate that coinfecti on with multiple EBV strains is much more prevalent in normal carriers than previously appreciated, which in turn has direct implications on EBV persi stence, host-viral interaction and pathogenesis. (Blood. 2000;95:2443-2445) (C) 2000 by The American Society of Hematology.