Chronic, active Epstein-Barr virus infection

Chronic active Epstein-Barr virus (EBV) infection is an uncommon outcome of EBV infection and may present as a waxing and waning or fulminant syndrome . Unlike acute infectious mononucleosis, wherein EBV establishes lifelong i nfection and survives by maintaining a delicate balance with the host as a latent infection, in chronic active EBV infection the host-virus balance is disturbed. The mechanisms by which this balance becomes perturbed are like ly to be heterogenous and may involve host immune factors, viral factors, o r both. A number of subtle immunologic defects have been reported in patien ts with chronic active EBV infection. Enhanced expression of viral genes ha s also been noted in some cases. Treatment of chronic active EBV infection has proven difficult, but new modalities including etoposide-based regimens and adoptive transfer of EBV-specific cytotoxic T lymphocytes have shown p romise, (C) 2000 Lippincott Williams & Wilkins, Inc.