Epstein-Barr virus (EBV) is prevalent in 90% of the population. After prima
ry infection it remains in a latent state and the majority of the virus car
riers are asymptomatic during their life. Among the immunocompromized patie
nts such as organ and bone marrow transplant recipients, individuals lackin
g T cell immunity, and patients treated with corticosteroid, cancer, and AI
DS patients EBV primary infection and reactivation can cause life threateni
ng diseases. Immunosupression may occur also during stressful events, which
induce corticosteroid release and thus activate EBV. The effect of examina
tion stress on EBV reactivation among female students was studied by detect
ing the values of EBV specific IgG and IgA salivary antibodies. Sequential
saliva samples were obtained from first year female students before, during
, and after two important examinations. EBV specific IgG and IgA salivary a
ntibodies were tested by enzyme-linked immunosorbent assay (ELISA). Hepatit
is A virus (HAV) salivary antibodies served as a non-latent virus control.
A statistically significant increase in the values of EBV specific IgG and
IgA antibodies was detected in samples collected during the examinations, a
s compared to the samples collected two months before and one month after t
he exams (P < 0.05). HAV antibody levels did not change significantly betwe
en the four time points. The menstrual cycle had no significant effect on t
he results. No significant symptoms were reported during the whole study. T
hese results indicate that among female students who endure stress during a
cademic examinations, a significant increase in EBV specific IgG and IgA sa
livary antibody values could be detected. EBV reactivation should be confir
med by measuring salivary EBV DNA or infectious virus. (C) 2001 Wiley-Liss,
Inc.