Symptoms of Epstein-Barr virus and methods of treating the disease

The Epstein-Barr virus is widespread on all continents and is recorded in both adults and children. In most cases, the course of the disease is benign and ends with recovery. An asymptomatic course is registered in 10 - 25% of cases, in 40% the infection occurs under the guise of an acute respiratory infection, in 18% of cases in children and adults infectious mononucleosis is registered.

In patients with reduced immunity, the disease proceeds for a long time, with periodic exacerbations, the appearance of complications and the development of adverse outcomes (autoimmune pathology and cancer) and secondary immunodeficiency states. Symptoms of the disease are varied. The leading ones are intoxication, infectious, gastrointestinal, cerebral, arthralgic and cardiac syndromes.

Treatment of Epstein-Barr virus infection (EBVI) is complex and includes antiviral drugs, immunomodulators, pathogenetic and symptomatic therapy. Children and adults after illness require long-term rehabilitation and clinical and laboratory monitoring.

Pathogen

Epstein-Barr virus (EBV) is a DNA virus from the Family Herpesviridae (gammaherpesviruses), is a type 4 herpesvirus. It was first identified from Burkett's lymphoma cells about 35-40 years ago.

The virus has a spherical shape with a diameter of up to 180 nm. The structure consists of 4 components: core, capsid, inner and outer shell. The core includes DNA, consisting of 2 strands, including up to 80 genes.

The viral particle contains specific antigens (proteins necessary for diagnosis):

• capsid antigen (VCA);
• early antigen (EA);
• nuclear or nuclear antigen (NA or EBNA); - membrane antigen (MA).

The significance and timing of their appearance in different forms of EBVI are not the same and have their own specific meaning.

The Epstein-Barr virus is relatively stable in the external environment and dies quickly when dried out, exposed to high temperatures, and exposed to common disinfectants.

In biological tissues and fluids, the Epstein-Barr virus can feel beneficial when it enters the blood of a patient with EBVI, brain cells of a completely healthy person, cells during oncological processes (lymphoma, leukemia, and others).

The virus has a certain tropism (tendency to infect favorite cells):

1. Affection of cells of the lymphoreticular system (damage to lymph nodes of any group occurs, enlargement of the liver and spleen);
2. Tropicness to cells of the immune system (the virus multiplies in B-lymphocytes, where it can persist for life, as a result of which their functional state is disrupted and immunodeficiency occurs); in addition to B-lymphocytes, EBVI also disrupts the cellular component of immunity (macrophages, NK - natural killer cells, neutrophils and others), which leads to a decrease in the body’s overall resistance to various viral and bacterial infections;
3. Affects the epithelial cells of the upper respiratory tract and digestive tract, due to which children may experience respiratory syndrome (cough, shortness of breath, “false croup”), diarrhea syndrome (loose stools).

The Epstein-Barr virus has allergenic properties, which is manifested by certain symptoms in patients: 20-25% of patients have an allergic rash, and some patients may develop Quincke's edema.

How can you get infected?

There are four variants of infection with the Epstein-Barr virus:

1. By airborne droplets. Herpes type 4 is transmitted by airborne droplets only when the source of infection is an acute form of Epstein-Barr virus infection. In this case, when sneezing, Epstein virus particles can easily become airborne and enter a new body.
2. Household contacts. In this case, we are primarily talking about all everyday contacts with an infected person, including shaking hands. And at the same time, it is not necessary that the carrier has an acute form of the disease, since another year and a half after the acute Epstein-Barr viral infection, the carrier can easily infect others through contact.
3. Sexual intercourse and kissing. Herpes type 4 is easily transmitted through all types of sexual interaction, as well as through kissing. It is believed that in a third of all infected people, Epstein-Barr can live in the saliva for the rest of their lives, so it is very easy to become infected with it.
4. From pregnant woman to child. If a pregnant woman has Epstein-Barr in her blood, then it can easily be transmitted from her to the fetus through the placenta, and in the future to the child.

Of course, understanding how easily it is possible to become infected with the Epstein-Barr virus, the question arises, what about blood transfusions or organ transplants. Naturally, it is also easy to get Epstein-Barr during transfusions and organ transplants, but the above transmission routes are the most common.

How does the disease develop?

Epstein-Barr virus most often enters the upper respiratory tract through airborne droplets.

Under the influence of infectious agents, epithelial cells of the mucous membrane of the nose, mouth and pharynx are destroyed and pathogens penetrate in large quantities into the surrounding lymphoid tissue and salivary glands.

Having penetrated B-lymphocytes, the pathogens spread throughout the body, primarily affecting the lymphoid organs - tonsils, liver and spleen.

In the acute stage of the disease, viruses infect one out of every thousand B-lymphocytes, where they multiply intensively and potentiate their division. When B lymphocytes divide, viruses are transmitted to their daughter cells. By integrating into the genome of infected cells, viral particles cause chromosomal abnormalities in them.

Some of the infected B-lymphocytes are destroyed as a result of the multiplication of viral particles in the acute phase of the disease.

But if there are few viral particles, then B-lymphocytes do not die so quickly, and the pathogens themselves, persisting for a long time in the body, gradually infect other blood cells: T-lymphocytes, macrophages, NK cells, neutrophils and vascular epithelium, which leads to the development secondary immunodeficiency.

Pathogens can reside in the epithelial cells of the nasopharyngeal region and salivary glands for a long time. Infected cells remain in the crypts of the tonsils for quite a long time (from 12 to 18 months), and when they are destroyed, viruses are constantly released into the external environment with saliva.

In HIV-infected people, EBVI manifests itself at any age.

Symptoms of Epstein-Barr virus

Acute infection (AVIEB) is infectious mononucleosis. The incubation period ranges from 2 days to 2 months, with an average of 5-20 days.

The disease begins gradually, with a prodromal period. The main symptoms are as follows: the patient complains of malaise, increased fatigue, and sore throat. Body temperature is slightly elevated or within normal limits. After a few days, the temperature rises to 39-40°C, and intoxication syndrome occurs.

The main symptom of acute Epstein-Barr virus infection is polyadenopathy. The anterior and posterior cervical lymph nodes, as well as the occipital, submandibular, supraclavicular, subclavian, axillary, ulnar, femoral and inguinal lymph nodes are mainly enlarged.

Their sizes reach 0.5-2 cm in diameter, they are doughy to the touch, moderately or slightly painful, and are not fused to each other and the surrounding tissues. The skin over them does not change.

The palatine tonsils are also involved in the process, which is manifested by signs of tonsillitis; the process is accompanied by impaired nasal breathing, a nasal voice, and the presence of purulent discharge on the back wall of the pharynx.

Acute Epstein-Barr virus infection rarely affects the nervous system. It is possible to develop serous meningitis, sometimes meningoencephalitis, encephalomyelitis, polyradiculoneuritis, but all processes end in complete regression of focal lesions. There is also a rash, which can be different. These may be spots, papules, roseola, dots or hemorrhages. Exanthema lasts about 10 days.

Chronic Epstein-Barr virus infection

CIVEB is characterized by a long duration and periodic relapses of the disease.

Patients complain of general fatigue, weakness, and increased sweating. Pain in the muscles and joints, exanthema, persistent cough in the form of grunting, and impaired nasal breathing may occur.

Headaches, discomfort in the right hypochondrium, mental disorders in the form of emotional lability and depression, weakening of memory and attention, decreased mental abilities and sleep disturbances are also noted.

There is generalized lymphadenopathy, hypertrophy of the pharyngeal and palatine tonsils, enlargement of the liver and spleen. Often, chronic Epstein-Barr virus infection is accompanied by bacteria and fungi (genital herpes and herpes lips, thrush, inflammatory processes of the digestive tract and respiratory system).

What diseases does the virus cause?

Diseases associated with the Epstein-Barr virus:

1. Chronic fatigue syndrome;
2. Infectious mononucleosis (multiglandular adenosis, glandular fever, Filatov's disease);
3. Lymphogranulomatosis (Hodgkin's disease);
4. Some of the non-Hodgkin's lymphomas, in particular Burkitt's lymphoma (Central African lymphoma);
5. Nasopharyngeal carcinoma (nasopharyngeal cancer);
6. Common variable immune deficiency;
7. Alice in Wonderland syndrome;
8. Hepatitis;
9. Herpes;
10. Stomatitis;
11. Post-transplant lymphoproliferative disease;
12. Multiple sclerosis;
13. Hairy leukoplakia;
14. Kikuchi-Fujimoto disease.

Diagnostics

Serological tests do not detect the virus itself in the blood, but the immune response to this virus.

Using serological reactions, antibodies to EBV infection can be detected:

1. Antibodies of class M (IgM) to the capsid antigen (VCA) are produced during the acute phase (from the first days after infection to 6 months from the onset of the disease) or exacerbation of chronic EBV infection.
2. Antibodies of class G (IgG) to the capsid antigen (VCA) - these immunoglobulins are produced after the acute period of the disease (3 weeks from the onset of the disease), during the period of convalescence their number increases, and they are also determined after the illness throughout life.
3. Antibodies of class G (IgG) to early antigen (EA) - like immunoglobulins of class M, this group of antibodies is produced in the acute phase of EBV infection (in the period from 1 week to 6 months from the onset of the disease).
4. Late antibodies of class G (IgG) to nuclear (or nuclear) antigen (EBNA) - appear after complete recovery, on average after 6 months, indicate the presence of stable immunity to EBV infection.

A positive result is a determination of the level of immunoglobulins above the established normal values. Each laboratory has its own standard indicators. It depends on the determination method, type of equipment, and units of measurement. Typically, normal indicators are indicated in the columns of the results obtained.

To accurately decipher the result of a laboratory test for EBV, it is advisable to use the table:

Stages of infection	anti-IgG-NA	anti-IgG-EA	anti-IgG-VCA	anti-IgM-VCA
There is no virus in the body	—	—	—	—
Primary infection	—	—	—	+
Primary infection in the acute stage	—	++	++++	++
Recent infection (up to six months)	—	++	++++	+
Infection occurred in the past	+	-/+	+++	—
Chronic course	-/+	+++	++++	-/+
The virus is in the stage of reactivation (exacerbation)	-/+	+++	++++	-/+
Presence of tumors caused by EBV	-/+	+++	++++	-/+

PCR diagnostics of Epstein-Barr virus

PCR diagnostics (polymerase chain reaction) is a laboratory research method that is aimed at identifying not the immune reaction, but the virus itself, its DNA.

This is a modern diagnostic method, the accuracy of which reaches 99.9%. The PCR method can examine blood, nasopharyngeal swabs, sputum, biopsy material of various tumor-like formations and any other biological materials.

PCR for EBV is prescribed for suspected generalized Epstein-Barr infection, for immunodeficiencies such as HIV, and in doubtful and complex clinical cases. This method can also be used in the presence of various oncological diseases. PCR is not used as a screening test for EBV (as the first test) due to its complexity and high cost of the study.

How to treat the virus?

Currently, there is no consensus among experts regarding the treatment regimen for Epstein-Barr virus infection in children and adults.

With infectious mononucleosis, patients are hospitalized in an infectious diseases hospital. In the acute period, in addition to the main therapy, they are prescribed semi-bed rest, plenty of fluids and dietary nutrition. Sweet, salty, smoked and fatty foods are excluded from the diet. Food should be taken often, in small portions. The menu must include fermented milk products, fresh vegetables and fruits.

Existing therapy for Epstein-Barr infection does not allow the patient to fully recover; the virus persists in the patient’s B-lymphocytes for life.

Drug therapy

Symptoms and treatment have a direct connection, because there is currently no specific therapy for the pathology. Taking medications is primarily aimed at eliminating symptoms. The patient is prescribed:

• antiviral drugs (Acyclovir, Valtrex, Famvir, Zovirax, Vitagerpavak, interferons: Viferon, intramuscular Roferon);
• immunoglobulins (i.v.: Intraglobin, BayRow-Di, i.m.: Rebinolin, Antigep);
• antihistamines to relieve tissue swelling (Suprastin, Diazolin, Fenkarol);
• multivitamin complexes to activate the body's defenses and normalize metabolism (Triovit, Supradin, Alphabet, Pikovit);
• biological stimulants to improve trophism and tissue regeneration (Actovegin, Biosed, Humisol),
• if necessary, the patient takes antipyretics, mucolytics, vasoconstrictors and other drugs.

The dosage of drugs and the duration of the course of therapy are determined by the attending physician.

Rehabilitation after infectious mononucleosis

1 month after the symptoms of the disease disappear, you must take a general blood test.

After 6 months, you need to check the viral load in the body. To do this, an ELISA test is performed to determine antibody titers. If the virus remains active in the body, it is necessary to take maintenance antiviral therapy in small doses. Patients with chronic EBV infection in remission need to take vitamin and mineral complexes to maintain immunity.

Prevention

There are no primary preventive measures to prevent infection with the Epstein–Barr virus. It is believed that the majority of adults are virus carriers, so measures aimed at strengthening the immune system are important to prevent exacerbations from occurring, i.e. secondary prevention. Such measures include:

• balanced diet;
• giving up bad habits (smoking, alcohol abuse);
• regular but moderate physical activity;
• maintaining a daily routine (a good night's rest is especially important);
• hardening procedures;
• avoiding stress, mental and physical overload;
• timely diagnosis and active treatment of any somatic and infectious diseases.

Forecast

The prognosis for infection with Epstein-Barr viruses is favorable. Complications leading to death are extremely rare.

Virus carriage poses a danger. Under unfavorable conditions, which may also be associated with decreased immunity, they can cause relapses of chronic infectious mononucleosis and manifest themselves in various malignant forms of Epstein-Barr infection.

Source: https://p-87.ru/health/virus-epshtejna-barra/

Epstein-Barr virus: symptoms and treatment in adults and children

Brief information

The described organism causes the development of many pathologies.

• The classic disease caused by herpes type 4 is infectious mononucleosis . Develops in the vast majority of cases.
• The major role of the virus in the formation of the most malignant and aggressive tumor - glioblastoma (brain cancer) has been proven.
• The agent is able to provoke an increase in the proliferative activity of the upper respiratory tract (pharynx, larynx).
• Severe lesions of the gastrointestinal tract - gastritis, ulcers, hepatitis.
• EBV provokes tumors of the lymphatic system.

Fatigue, weakness, and constant weakness can be caused by this viral agent. The condition is known as chronic fatigue syndrome.

Despite such a wide list of possible diseases, typical mononucleosis develops in 90% of cases.

Causes of infection

The infection is highly contagious. In practice, this means that infection occurs in various ways and regardless of the state of immunity of the potential carrier. There are several ways EBV can enter the body:

• Contact. Handshakes, kisses, that is, interaction with the mucous membranes and dermis of an infected person are the most common route of infection .
• Airborne. With cough, saliva and other biological fluids, the agent enters the environment and penetrates into organisms.

The immediate causes can be determined as follows:

• Contact with a sick person.
• Interaction with biological fluids of an infected person (medical workers are primarily at risk).
• Unprotected sexual intercourse. Adults can get EBV as a result of a promiscuous intimate life.
• Using household items of a sick person.

Infection can also be congenital. In this case, the agent enters the child's body as it passes through the birth canal. There is a high risk of becoming a carrier through blood transfusion.

Typical symptoms

Symptoms are mostly defined in the context of the most common disease caused by EBV: infectious mononucleosis. In the acute phase, the disease is manifested by the following symptoms:

• General intoxication. This is the prodromal period of pathology formation. The process begins in the second or third week and manifests itself nonspecifically. At the end of the incubation period, primary symptoms of a general nature are formed. It is extremely difficult to distinguish mononucleosis from a simple cold at this stage; the symptoms are almost identical.
• After 3-5 days, a typical picture of an infectious lesion begins to emerge. Complex lymphadenitis develops . All lymph nodes become inflamed, including the inguinal and submandibular ones. The acute phase of lymphadenitis lasts about 14 days and resolves on its own. In some cases, complications may form - abscesses and suppuration of nodes.
• Rash. Another pathognomonic sign. The entire body is covered with red papules filled with transparent exudate. When scratching, herpes is mechanically transferred to healthy skin and mucous membranes, causing further infection. The rash may look like pinpoint hemorrhages.
• Enlarged spleen - causes pain in the side when breathing.
• Enlarged liver. It provokes a number of consequences: pain in the right hypochondrium, nausea, vomiting, change in the nature of the stool (it becomes colorless, liquid in consistency). With excessive enlargement of the liver, secondary jaundice may begin.
• Herpetic sore throat. Sore throat, difficulty breathing, white rashes in the area of ​​the pharyngeal ring are constant companions of the pathology.
• In severe cases, the virus can infect cerebral structures. Meningitis begins.

Acute mononucleosis lasts approximately 1-2 months and often resolves on its own without medical attention . However, in this case, the risk of adverse consequences for the patient’s body increases. An uncorrected condition leads to increased virus activity. When exposed to healthy tissue, EBV increases the proliferative activity of cytological units, causing manifestations of nuclear cell atypia. This is a direct path to neoplastic processes.

The disease can occur in a chronic form. In this case, the symptoms are scant or completely absent.

Diagnostic measures

Diagnosis involves visiting an otolaryngologist. Additionally, consultation with an infectious disease specialist will be required. The doctor interviews the patient about complaints and their nature. Collects life history. However, it is almost impossible to determine the moment of infection. Visual assessment of the nasopharynx plays an important role. Specialized studies should confirm the presence of herpes lesions:

• General blood test. Demonstrates a classic picture of inflammation with an increase in the number of leukocytes and monocytes. ESR is increasing.
• Biochemistry of venous blood. Alkaline phosphatase, bilirubin, and specific substances indicating liver pathologies increase.
• PCR and ELISA. Designed to detect the presence of viral DNA in the patient’s body.
• Immune tests. Necessary to determine the presence of specific antibodies in the blood.

To exclude pathological changes in the abdominal organs, radiography and ultrasound examination of the peritoneal organs are indicated.

Treatment

Treating Epstein-Barr virus is an impossible task. Therapy can be selected so that the pathogen subsides and the disease goes into remission, but it is impossible to completely cure the disease and get rid of the pathological agent. But even this task is very difficult.

Treatment for acute mononucleosis is exclusively inpatient in an infectious diseases department.

The following medications are indicated:

• Antiherpetic antiviral drugs - fight the pathogen. The use of Acyclovir, Valacyclovir, Valtrex (an analogue of Valacyclovir), Zovirax is indicated. These drugs have a selective effect on EBV DNA, reduce the proliferative activity of cells, preventing the development of complications.
• Antibiotics - these medications fight secondary infections.
• Immunomodulators - normalize the functioning of the immune system, promoting the synthesis of interferon. Viferon, Cycloferon and other drugs.
• In the presence of hyperthermia, taking antipyretic drugs based on paracetamol or ibuprofen is indicated.

Treatment must be comprehensive. The treatment regimen is selected by the attending physician, as well as the number of tablets per day. The duration of the course is about 2-3 months.

Additional treatment with folk remedies is possible. In no case can it replace traditional therapy, but it can be a good help. Herbal medicine is designed to relieve symptoms. You can resort to two methods:

1. Use of propolis . The alcohol tincture is prepared as follows: cool and grind 100 grams of raw materials. Pour water and leave for 2-3 hours. Pour the infusion into a container, add 250 ml of medical alcohol or vodka. Let it brew for two weeks. Use half a teaspoon twice a day. Thus, EBV is treated until the condition improves.
2. Taking echinacea. An effective herb to combat herpes and its manifestations. It is better to use a ready-made product sold in a pharmacy.

Treatment methods for children and adults are the same. The only difference is the drug regimen approved by the doctor.

Prevention

There are no specific recommendations for preventing Epstein-Barr virus infection.

It is enough to keep your immune system in good shape, eat right and observe the rules of personal hygiene in order to never encounter manifestations of mononucleosis and minimize the risks of developing other associated pathologies.

EBV is an insidious enemy of the human body. No one can predict in advance how the agent will behave at the next moment: it is possible to exist in a latent form throughout his life. It is impossible to recover from it, but it is in the hands of a person to prevent an increase in the body’s activity. If suddenly the virus makes itself known, it is necessary to urgently contact an infectious disease doctor to prescribe specific therapy.

Learn more about the symptoms and treatment of Epstein-Barr virus Link to main publication

Source: https://GerpInfo.com/gerpes/epshtejna-barr.html

Epstein-Barr virus: symptoms of infection, diagnosis and treatment of EBV

Epstein-Barr virus (EBV) is the cause of chronic persistent infection from the group of herpesvirus pathogens (herpes virus type 4). The source of EBV infection is a sick person or a virus carrier. Transmission of the virus can occur by airborne droplets, sexual contact and household contact through saliva, sputum, vaginal and urethral secretions, and blood. According to available data, about 80% of the population is infected with EBV.

Diseases caused by EBV

Epstein-Barr viral infection usually occurs in children and young adults. However, they can be observed at any age. The clinical manifestations of the infection are extremely diverse and have varied symptoms, which greatly complicates diagnosis.

As a rule, manifestations of EBV develop against the background of decreased immunity, which is characteristic of all herpesvirus infections. Primary forms of the disease and its relapses are always associated with congenital or acquired immunodeficiency.

People with severe immunodeficiency experience generalized forms of infection affecting the central nervous system, liver, lungs and kidneys. Often, severe forms of EBV infection may be associated with HIV infection.

Attention!

It has now been established that EBV is also associated with a number of oncological, mainly lymphoproliferative and autoimmune diseases (classical rheumatic diseases, vasculitis, ulcerative colitis, etc.). In addition, EBV causes manifest and latent forms of the disease, which occur as acute and chronic mononucleosis.

Course of EBV infection

In people with normal immunity, after infection with EBV, two options are possible. The infection may be asymptomatic or manifest itself in the form of minor symptoms resembling influenza or acute respiratory viral disease (ARVI). However, in case of infection against the background of an existing immunodeficiency, the patient may develop a picture of infectious mononucleosis.

In the event of the development of an acute infectious process, several options for the outcome of the disease are possible:
– recovery (DNA of the virus can be detected only with a special study in single B-lymphocytes or epithelial cells);
– asymptomatic virus carriage or latent infection (the virus is determined in saliva or lymphocytes in the laboratory);
– development of a chronic relapsing process:
a) chronic active EBV infection of the type of chronic infectious mononucleosis;
b) a generalized form of chronic active EBV infection with damage to the central nervous system, myocardium, kidneys, etc.;
c) erased or atypical forms of EBV infection: prolonged low-grade fever of unknown origin, recurrent bacterial, fungal, often mixed infections of the respiratory and gastrointestinal tract, furunculosis;
d) development of oncological diseases (Burkitt's lymphoma, nasopharyngeal carcinoma, etc.);
e) development of autoimmune diseases;

f) EBV-associated chronic fatigue syndrome.

The outcome of an acute infection caused by EBV depends on the presence and severity of immune deficiency, as well as on the presence of a number of external factors (stress, concomitant infections, surgical interventions, hyperinsolation, hypothermia, etc.) that can disrupt the functioning of the immune system.

Clinical manifestations of EBV infection

Clinical manifestations of diseases caused by EBV largely depend on the severity of the process. The primacy of the infectious process or the occurrence of clinical symptoms of chronic infection is also important. In the case of the development of an acute infectious process due to EBV infection, a picture of infectious mononucleosis is observed. It usually occurs in children and young adults.

• The development of this disease leads to the appearance of the following clinical signs:
  – increased temperature,
  – enlargement of various groups of lymph nodes,
  – damage to the tonsils and hyperemia of the pharynx.
• Quite often there is swelling of the face and neck, as well as an enlargement of the liver and spleen.

In the case of chronically active EBV infection, a long-term relapsing course of the disease is observed.

Patients are concerned about: weakness, sweating, often pain in muscles and joints, the presence of various skin rashes, cough, discomfort in the throat, pain and heaviness in the right hypochondrium, headaches, dizziness, emotional lability, depressive disorders, sleep disturbances, decreased memory, attention , intelligence. Low-grade fever, enlarged lymph nodes and hepatosplenomegaly of varying severity are often observed. Usually this symptomatology has a wave-like character.

In patients with severe immune deficiency, generalized forms of EBV infection may occur with damage to the central and peripheral nervous systems (the development of meningitis, encephalitis, cerebellar ataxia, polyradiculoneuritis), as well as damage to other internal organs (the development of myocarditis, glomerulonephritis, lymphocytic interstitial pneumonitis, severe forms of hepatitis). Generalized forms of EBV infection can be fatal.

With erased forms of infection, the patient may be bothered by wave-like low-grade fever, pain in the muscles and lymph nodes, weakness, and sleep disturbances.

In the case of an infectious process under the guise of another disease, the most important signs are: duration of symptoms and resistance to therapy.

Laboratory research

Considering that it is impossible to make a clinical diagnosis of EBV infection, laboratory diagnostic methods are leading in determining the disease.

They can be divided into two groups: screening and clarifying:

1. Screening tests include those that, along with clinical symptoms, allow one to suspect EBV infection. In a clinical blood test: slight leukocytosis, lymphomonocytosis, possibly thrombocytopenia may be observed.

A biochemical blood test reveals: increased levels of transaminases and other enzymes, acute phase proteins - C-reactive protein, fibrinogen, etc.

However, these changes are not strictly specific to EBV infection (they can also be found in other viral infections).

2. An important study to determine the presence of a pathogen in the body is a serological examination: an increase in titers of antibodies to EBV is a criterion for the presence of an infectious process at the present time or evidence of contact with an infection in the past. However, the presence of antibodies does not allow us to say unambiguously that the clinical manifestations of the disease are caused by EBV.

3. To obtain the most reliable results, DNA diagnostics is used. Using the polymerase chain reaction (PCR) method, EBV DNA is determined in various biological materials: saliva, blood serum, leukocytes and peripheral blood lymphocytes.

If necessary, research is carried out in biopsy samples of the liver, lymph nodes, intestinal mucosa, etc.

Thus, to make a diagnosis of EBV infection, in addition to general clinical examinations, serological tests (ELISA) and DNA diagnostics of infection in various materials over time are necessary.

Treatment of EBV infection

Currently, there are no generally accepted treatment regimens for EBV infection. The volume of therapy for patients with both acute and chronic active EBV infection may vary, depending on the duration of the disease, the severity of the condition and immune disorders.

In the complex treatment of this disease, various groups of drugs are used, including recombinant interferons, which suppress the reproduction of the virus, protect uninfected cells, and strengthen the immune system.

Depending on the severity of certain symptoms of the disease, various symptomatic therapy is prescribed (analgesics, antioxidants, non-steroidal anti-inflammatory drugs, mucolytics, etc.).

Interferon in the treatment of disease

The drug of choice for the treatment of EBV infection may be interferon-alpha, which in moderate cases is prescribed as monotherapy.

The rationale for including antiviral immune agents (interferons) in the therapeutic complex is that clinical manifestations of infection are usually associated with immunodeficiency states of varying severity. With EBV infection, there is always a reduced production of its own interferon.

Considering that EBV infection is a chronic, persistent disease, interferon therapy can also be recommended as a prevention of exacerbations. In this case, a course of treatment is prescribed, the duration of which depends on the severity of the disease.

From the group of recombinant interferons, the drug VIFERON® Suppositories can be prescribed.

The combination of the main active ingredient interferon alpha-2b and highly active antioxidants: alpha-tocopherol acetate and ascorbic acid (presented in the dosage form as a mixture of ascorbic acid/sodium ascorbate) allows you to reduce the therapeutically effective concentration of interferon alpha-2b and avoid the side effects of interferon therapy. In the presence of ascorbic acid and its salt and alpha-tocopherol acetate, the specific antiviral activity of interferon increases, its immunomodulatory effect is enhanced and interferon levels are normalized.

Treatment of EBV infection must be carried out under the supervision of a clinical blood test (once every 7-14 days), a biochemical analysis (once a month, more often if necessary), and an immunological study - after one to two months.

Corresponding member RANS, professor A.A. Khaldin, MD, President of the Herpes-Forum NP.

Source: https://viferon.su/epshtejna-barr-virusnaya-infekciya/

How to treat Epstein-Barr virus in adults - regimen and medications

In 40% of cases, adults and children get herpes infection. However, this family of pathogens has many variations. This infection includes the Epstein-Barr virus.

Pathogens remain dormant in the body for a long time, and as soon as immunity decreases, their activity begins. In this case, the patient needs to know which doctor to contact and how Epstein-Barr treatment is carried out.

Timely therapy will prevent the development of the disease and will not lead to complications.

Which doctor is treating you?

If symptoms of EBV (Epstein-Barr virus) appear, you need to contact an infectious disease specialist or immunologist.

When tumor-like formations begin to appear, an oncologist treats the Epstein-Barr virus. The patient is diagnosed by an appropriate specialist.

To determine which treatment package needs to be prescribed, the doctor should familiarize himself with the results of the medical history, laboratory tests and examination of the patient.

To determine Epstein-Barr infection, a general condition is distinguished:

• intoxication of the body;
• temperature increase;
• fever;
• lymph nodes are enlarged;
• difficulty breathing.

In laboratory tests, in the presence of the virus, an enlargement of the liver and spleen is observed. In the results of a general blood test, changes in the increase in the level of lymphocytes and monocytes are noted.

During the course of infection, the number of segmented neutrophils decreases. The ESR indicator is able to remain at the same level. If the result changes, this has little effect on the overall condition.

When the infection affects the liver, an increase in bilirubin is noted.

How is Epstein-Barr virus treated?

Treatment of Epstein-Barr virus (EBV) in children and adults.

There are no specific comprehensive measures for treatment of Epstein-Barr virus. If the immune system is not weakened, then the body recovers without the use of therapy.

This requires providing the patient with constant replenishment of the water balance. To eliminate the clinical manifestations of Epstein-Barr disease in an adult, antipyretics are prescribed.

Otherwise, painkillers help. This is included in general restoration measures.

General treatment regimen

If EBV manifests itself in the form of infectious mononucleosis, then no special therapy is performed. In this case, medications containing acyclovir are of no benefit. In case of severe manifestation of pathogen activity, the general treatment regimen for Epstein-Barr virus in adults consists of taking medications, vitamin complexes and maintaining immunity.

In chronic or acute cases of the disease, the use of glucocorticosteroids is prescribed. Prednisolone is prescribed to treat Epstein-Barr infection. The dosage for severe infections is 0.001 g/kg per day. The recovery course lasts 1 week. In addition, the drug is recommended to use medications to eliminate other symptoms of the disease.

If a secondary infection is added to the disease, then Epstein-Barr virus in adults must be treated with antibiotics. At the same time, the dosage of medications is observed.

The exception includes medications containing aminopenicillin. Acyclovir or Ganciclovir are used as etiotropic drugs.

Prednisolone and Ganciclovir.

1 2

When the chronic form of Epstein-Barr virus disease occurs in adults, treatment involves the use of Interferon Alpha.

At the same time, the dosage of the drug is 1 million IU per 1 m2 of the patient’s body area. The drug is administered 2 times a day every 12 hours. The course of treatment is 7 days.

Then the medicine is administered every day 3 times a week. The duration of treatment is 180 days.

For Epstein-Barr infection in adults, Acyclovir is prescribed; in addition, the medicine is also indicated for use in herpes zoster. To eliminate some symptoms, the ointment is applied to the inflamed areas. Doctors recommend rubbing the medicine up to 5 times a day.

In addition to medications, general therapy includes vitamin and mineral complexes to maintain the condition of the immune system. Doctors recommend that the patient review his diet and add more vegetables and fruits to his diet.

What medications are used to treat Epstein-Barr virus?

The disease has unpleasant clinical manifestations. Therefore, the use of drugs in the treatment of Epstein-Barr virus in adults is symptomatic. In addition to general medications, therapeutic measures are prescribed:

1. "Ganciclovir";
2. "Alpha Interferon";
3. "Prednisolone."

When treating EBV, the drug Ganciclovir is used, which is administered intravenously. The dosage is up to 0.015 g/kg 3 times every day. The course of treatment is 2 weeks. In individual cases, the drug is used for up to 20 days.

If the infection is chronic, the dosage is 0.005 g/kg. This is carried out during a prophylactic course to avoid recurrence of infection. In this case, the injections continue for a long time.

In addition, Ganciclovir tablets are actively used.

For severe Epstein-Barr infection in adults, potent medications are used, which include immunoglobulin. The drug is used for internal administration. The dosage is 4 ml/kg during the day. During the course of treatment, do not exceed 2 g/kg of medication per day.

Is the virus treated at home or with traditional medicine?

Treatment at home for Epstein-Barr virus in adults does not differ from inpatient conditions. However, doctors allow you to take some medications at home. However, self-medication is not allowed. To get a positive result, you need to interact with qualified specialists.

It will take much longer to cure the Epstein-Barr virus using traditional medicine than in a hospital. In addition, to use herbal remedies, you will need to consult with your doctor. Traditional medicine is used as an additional therapy to consolidate the positive results of treatment.

Some symptoms of the disease begin to appear after infection with the Epstein-Barr virus. Therefore, you need to pay attention to your health status rather than wait for serious signs of infection.

Therapeutic measures for Epstein-Barr disease are more effective if the patient recovers in a hospital setting. In this case, the general treatment regimen consists of taking medications and vitamin complexes. Some drugs are given by injection.

Self-treatment and administration of medications in the wrong dosage will lead to unpleasant consequences.

Source: https://herpes.center/gerpesvirus/lechenie-virusa-ehpshtejna-barr

Epstein-Barr virus

Epstein-Barr virus belongs to the herpesvirus family (herpes type 4) and is the most common and highly contagious viral infection.

According to statistics, up to 60% of children and almost 100% of adults are infected with this virus. The Epstein-Barr virus is transmitted by airborne droplets (kissing), household contact (shared household items), less commonly through blood (transmissible) and from mother to fetus (vertical route).

The source of infection is only humans, most often these are patients with latent and asymptomatic forms. The Epstein-Barr virus enters the body through the upper respiratory tract, from where it penetrates the lymphoid tissue, causing damage to the lymph nodes, tonsils, liver and spleen.

What diseases does it cause?

The Epstein-Barr virus is dangerous not so much because of its acute infection of humans, but because of its tendency to cause tumor processes. There is no unified classification of Epstein-Barr virus infection (EBVI); the following is proposed for use in practical medicine:

• by time of infection - congenital and acquired;
• according to the form of the disease - typical (infectious mononucleosis) and atypical: erased, asymptomatic, damage to internal organs;
• according to the severity of the course - mild, moderate and severe;
• according to the duration of the course - acute, protracted, chronic;
• by activity phase – active and inactive;
• complications;
• mixed (mixed) infection - most often observed in combination with cytomegalovirus infection.

Diseases caused by the Epstein-Barr virus:

• Filatov's disease (infectious mononucleosis);
• Hodgkin's disease (lymphogranulomatosis);
• chronic fatigue syndrome;
• malignant formation of the nasopharynx;
• lymphomas, including Burkitt's lymphoma;
• general immune deficiency;
• systemic hepatitis;
• damage to the brain and spinal cord (multiple sclerosis);
• herpes;
• tumors of the stomach and intestines, salivary glands;
• hairy leukoplakia of the oral cavity and others.

Symptoms of Epstein-Barr virus

• Acute infection (AVIEB)
• CVIEB is infectious mononucleosis.
• The incubation period ranges from 2 days to 2 months, with an average of 5-20 days.
• The disease begins gradually, with a prodromal period: the patient complains of malaise, increased fatigue, and sore throat.

Body temperature is slightly elevated or within normal limits.

After a few days, the temperature rises to 39-40°C, and intoxication syndrome occurs.

The main symptom of acute Epstein-Barr virus infection is polyadenopathy. The anterior and posterior cervical lymph nodes, as well as the occipital, submandibular, supraclavicular, subclavian, axillary, ulnar, femoral and inguinal lymph nodes are mainly enlarged.

Their sizes reach 0.5-2 cm in diameter, they are doughy to the touch, moderately or slightly painful, and are not fused to each other and the surrounding tissues. The skin over them does not change.

The palatine tonsils are also involved in the process, which is manifested by signs of tonsillitis; the process is accompanied by impaired nasal breathing, a nasal voice, and the presence of purulent discharge on the back wall of the pharynx.

Enlarged spleen (splenomegaly) is one of the late signs; the spleen returns to normal size after 2-3 weeks of illness, less often after 2 months.

Enlarged liver (hepatomegaly) is less common. In some cases, mild jaundice and darkening of the urine are observed.

Acute Epstein-Barr virus infection rarely affects the nervous system. It is possible to develop serous meningitis, sometimes meningoencephalitis, encephalomyelitis, polyradiculoneuritis, but all processes end in complete regression of focal lesions.

There is also a rash, which can be different. These may be spots, papules, roseola, dots or hemorrhages. Exanthema lasts about 10 days.

Chronic Epstein-Barr virus infection

CIVEB is characterized by a long duration and periodic relapses of the disease.

Patients complain of general fatigue, weakness, and increased sweating. Pain in the muscles and joints, exanthema (rash), persistent cough in the form of grunting, and impaired nasal breathing may occur.

Headaches, discomfort in the right hypochondrium, mental disorders in the form of emotional lability and depression, weakening of memory and attention, decreased mental abilities and sleep disturbances are also noted.

There is generalized lymphadenopathy, hypertrophy of the pharyngeal and palatine tonsils, enlargement of the liver and spleen. Often, chronic Epstein-Barr virus infection is accompanied by bacteria and fungi (genital herpes and herpes lips, thrush, inflammatory processes of the digestive tract and respiratory system).

Diagnostics

The diagnosis of acute and chronic Epstein-Barr infection is made on the basis of complaints, clinical manifestations and laboratory data:

1. General blood test

Increased leukocytes, ESR, increased lymphocytes and monocytes, detection of atypical mononuclear cells. There may be a decrease or increase in platelets and hemoglobin (hemolytic or autoimmune anemia).

1. 2. Biochemical blood test
2. Increased AST, ALT, LDH and other enzymes, detection of acute phase proteins (CRP, fibrinogen), increased bilirubin and alkaline phosphatase.
3. 3. Immunological study
4. The state of the interferon system, immunoglobulins, etc. is assessed.
5. 4. Serological reactions

The method of enzyme immunoassay is used, through which the quantity and class of immunoglobulins (antibodies to the Epstein-Barr virus) are assessed. In the acute stage or during exacerbation, IgM predominates, and later, after 2-4 months, IgG predominates.

Reference values:

IgM antibodies

• <20 U/ml - negative;
• > 40 U/ml - positive; 
• 20 – 40 U/ml – doubtful*.

IgG antibodies:

• <20 U/ml - negative;
• > 20 U/ml – positive*.

• according to independent laboratory Invitro
• 5. DNA diagnostics
• Using the polymerase chain reaction (PCR) method, the presence of Epstein-Barr virus DNA is determined in various biological materials (saliva, cerebrospinal fluid, smears from the mucous membrane of the upper respiratory tract, biopsies of internal organs).
• 6. If indicated, other studies and consultations
• Consultation with an ENT doctor and immunologist, X-ray of the chest and paranasal sinuses, ultrasound of the abdominal cavity, assessment of the blood coagulation system, consultation with an oncologist and hematologist.

Treatment of Epstein-Barr virus infection

There is no specific treatment for Epstein-Barr virus infection. Treatment is carried out by an infectious disease specialist (for acute and chronic infections) or an oncologist for the development of tumor-like neoplasms.

All patients, especially those with infectious mononucleosis, are hospitalized. An appropriate diet and rest are prescribed for the development of hepatitis.

1. Various groups of antiviral drugs are actively used: isoprinosine, Valtrex, acyclovir, Arbidol, Viferon, intramuscular interferons (Reaferon-EC, Roferon).
2. If necessary, antibiotics (tetracycline, sumamed, cefazolin) are included in therapy - for example, for a sore throat with extensive plaque, a course of 7-10 days.
3. Intravenous immunoglobulins (intraglobin, pentaglobin), complex vitamins (sanasol, alphabet), and antiallergic drugs (tavegil, fenkarol) are also prescribed.
4. Correction of immunity is carried out by prescribing immunomodulators (lykopid, derinat), cytokines (leukinferon), biological stimulants (actovegin, solcoseryl).
5. Relief of various symptoms of the disease is carried out with antipyretics (paracetamol) when the temperature rises, for coughs - antitussives (libexin, mucaltin), for difficulties with nasal breathing, nasal drops (nazivin, adrianol), etc.
6. The duration of treatment depends on the severity and form (acute or chronic) of the disease and can range from 2-3 weeks to several months.

Complications and prognosis

Complications of acute and chronic Epstein-Barr virus infection:

• otitis;
• peritonsillitis;
• respiratory failure (swelling of the tonsils and soft tissues of the oropharynx);
• hepatitis;
• splenic rupture;
• hemolytic anemia;
• thrombocytopenic purpura;
• liver failure;
• pancreatitis, myocarditis.

The prognosis for acute infection with the Epstein-Barr virus is favorable. In other cases, the prognosis depends on the severity and duration of the disease, the presence of complications and the development of tumors.

Source: https://www.diagnos.ru/diseases/infec/epstein-barr