Treatment of Epstein Barr virus consequences. Epstein Barr virus - what to do and what to do? Immunity disorders

Many people on the planet have Epstein Barr virus. Symptoms in adults are often confused with other diseases, leading to ineffective treatment.

Symptoms resembling ARVI are caused by the Epstein Barr virus. Symptoms in adults are determined by the strength of the body's immune defense, but treatment is symptomatic. This virus belongs to the herpes family, namely type 4. EBV has the ability to remain in the host’s body for quite a long time, in some cases throughout life.

While in the human body, the causative agent of the disease is capable of causing the development of lymphoproliferative and autoimmune pathologies. The most common manifestation is mononucleosis. In adult patients, transmission of the viral agent occurs during kissing through salivary fluid. A huge number of virions are found in its cells.

Incubation of the Epstein Barr viral agent lasts from 30 to 60 days. At the end of this period, a violent attack begins on the tissue structures of the epidermis and lymph nodes, then the virus migrates into the bloodstream and affects all organs and systems of the body.

Symptoms do not appear immediately; they gradually increase in a certain sequence. In the first phase, symptoms practically do not appear or are very mild, as in an acute respiratory viral infection.

After a chronic viral infection affects the human body, the following symptoms develop:

headache;
sweating increases;
spasmodic pain in the upper quadrant of the abdomen;
complete weakness of the body;
nausea, sometimes turning into vomiting;
problems with fixation of attention and partial memory loss;
increase in body temperature up to 39°C;
a pale papular-spotted rash is observed in 15% of infected people;
sleep problems;
depressive states.

A distinctive feature of the infectious process is enlargement of the lymph nodes and their redness, plaque forms on the tonsils, mild hyperemia of the tonsils develops, a cough is added, a pain in the throat when swallowing and at rest, breathing through the nose becomes difficult.

The infection has phases of increasing and subsiding symptoms. Most victims confuse important signs of pathology with indolent flu.

EBV is often transmitted together with other infectious agents: fungi (thrush) and pathogenic bacteria that cause gastrointestinal diseases.

Potential danger of Epstein-Barr virus

Epstein Barr virus in adults can cause the following complications:

inflammation of the meninges and/or brain;
polyradiculoneuritis;
disturbances in the normal functioning of the glomeruli of the kidneys;
inflammation of the heart muscle;
severe forms of hepatitis.

It is the development of one or several complications at once that can cause death. Epstein Barr virus can lead to various pathologies in the body.

Infectious mononucleosis

This pathology develops in 3 out of 4 patients infected with the Epstein Barr virus. The victim feels weak, the body temperature rises and can last up to 60 days. The process of damage involves the lymph nodes, pharynx, spleen, and liver. Small rashes may appear on the skin. If mononucleosis is not treated, the symptoms will disappear after 1.5 months. This pathology is not characterized by repeated manifestations, but the risk of deterioration cannot be excluded: autoimmune hemolytic anemia, damage to the central nervous system and cranial nerves.

Chronic fatigue and its manifestations

The main symptom of chronic fatigue syndrome is unreasonable anger. Afterwards, depressive disorders, pain in muscles and joints, and problems with fixation of attention are added. This is due to the Epstein Barr virus.

Lymphogranulomatosis

First of all, the lymph nodes in the cervical and subclavian region enlarge; there is no pain on palpation. When tissue becomes malignant, the process may spread to other organs and systems.

African malignant lymphoma

Lymphoid lesion is a malignant neoplasm involving the lymph nodes, ovaries, adrenal glands and kidneys in the pathological process. The disease develops very quickly, and without appropriate treatment leads to an unfavorable outcome.

Cancer of the nasopharynx

Belongs to a class of tumor formations that is localized on the lateral wall of the nose and grows into the back of the nasal cavity with the destruction of lymph nodes by metastases. With further development of the disease, purulent and mucous discharge from the nose occurs, nasal breathing becomes difficult, buzzing in the ears and weakening of hearing acuity.

If the virus affects a person’s immune system, the central nervous system, liver, and spleen begin to suffer. The victim develops jaundice, mental disorders and paroxysmal pain in the stomach.

One of the most dangerous complications is splenic rupture, which is characterized by severe pain in the left abdomen. In such a situation, urgent hospitalization and specialist assistance are necessary, since the resulting bleeding may result in the death of the patient.

If you suspect the presence of the Epstein Barr virus in a person’s body, you should immediately seek specialized help and carry out a set of diagnostic measures. This allows for early stages and reduces the risk of complications.

Diagnosis of Epstein Barr virus

In order to detect the Epstein Barr virus, the doctor must examine the suspected patient and collect an anamnesis. To make an accurate diagnosis, the diagnostic scheme includes the following measures and procedures.

Biochemical diagnostics of blood.
Clinical blood diagnostics, which allows to identify leukocytosis, thrombocytopenia, neutropenia.
Establishing the titer of specific antibodies.
to determine antibodies to Epstein Barr virus antigens.
An immunological test to determine malfunctions of the immune system.
Culture method.

All of the above studies and manipulations will help determine the presence of a pathological process in both men and women as early as possible. This will help start timely therapy and prevent the development of unpleasant complications.

Therapeutic measures

Unfortunately, modern medicine does not offer specific

With strong immune protection, the disease can go away on its own, without the use of medication or procedures. The victim must be surrounded by absolute peace, and he must also maintain a drinking regime. With elevated body temperature and painful sensations, it is possible to use painkillers and antipyretics.

If the pathological process degenerates into a chronic or acute form, the patient is referred to an infectious disease specialist, and if it worsens in the form of tumors, they seek help from an oncologist.

The duration of treatment for the Epstein Barr virus depends on the degree of damage to the body and can range from 3 to 10 weeks.

After conducting immunological studies and identifying abnormalities in the functioning of the immune system, it is necessary to include the following groups of medications in the treatment regimen:

In order to increase the pharmacological activity of the above medications, the following positions can be used:

antiallergic drugs;
bacteria to restore intestinal microflora;
hepatoprotectors;
enterosorbents.

To determine the effectiveness of the prescribed therapy and the patient’s body’s response to the proposed therapy, it is necessary to take a clinical blood test every week and carry out a biochemical study of the blood composition every month.

In case of severe symptoms and complications, the patient should be treated in an inpatient setting at an infectious diseases hospital.

For the entire period of treatment for the Epstein Barr virus, you should strictly adhere to the doctor’s recommendations and the daily regimen he has drawn up, as well as follow a diet. In order to stimulate the body, the doctor recommends an individual set of gymnastic exercises.

If mononucleosis of infectious origin is detected, the patient is additionally prescribed antibacterial therapy (Azithromycin, Tetracycline) for a period of 8-10 days. During this time, the patient should be at constant rest and rest as much as possible to reduce the risk of splenic rupture. Lifting heavy objects is prohibited for 2-3 weeks, in some cases even 2 months.

To avoid re-infection with the Epstein Barr virus, you should go to a sanatorium for a while for wellness treatments.

In people who have encountered and recovered from the Epstein Barr virus, the IgG class is found in the body. They persist throughout life. The Epstein Barr virus is not as scary as it is described, the main thing is to seek treatment in time.

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.

Rice. 1. The photo shows the Epstein-Barr virus. View under an electron microscope.

Epstein-Barr virus

Epstein-Barr virus was discovered in 1964 by M. Epstein and Y. Barr. Belongs to the family of herpes viruses (it is a herpes virus type 4), the subfamily of gamma viruses, and the genus of lymphocryptoviruses. The pathogen contains 3 antigens: nuclear (EBNA), capsid (VCA) and early (EA). The viral particle consists of a nucleotide (contains double-stranded DNA), a capsid (consists of protein subunits) and a lipid-containing envelope.

Viruses target B lymphocytes. In these cells, pathogens are able to remain for a long time and, with a decrease in the functioning of the immune system, become the cause of the development of chronic Epstein-Barr virus infection, a number of severe oncological pathologies of a lymphoproliferative nature, autoimmune diseases and chronic fatigue syndrome.

As viruses multiply, they activate the division of B lymphocytes and are transmitted to their daughter cells. Mononuclear cells—atypical lymphocytes—appear in the patient’s blood.

Pathogens, thanks to a large set of genes, are able to evade the human immune system. And their greater ability to mutate allows viruses to avoid the effects of antibodies (immunoglobulins) developed before mutation. All this causes the development of secondary immunodeficiency in those infected.

Specific antigens of the Epstein-Barr virus (capsid, nuclear, membrane) are formed sequentially and induce (promote) the synthesis of corresponding antibodies. Antibodies in the patient’s body are produced in the same sequence, which makes it possible not only to diagnose the disease, but also to determine the duration of infection.

Rice. 2. The photo shows two Epstein-Barr viruses under a microscope. The genetic information of virions is enclosed in a capsid - a protein shell. The outside of the virions is loosely surrounded by a membrane. The capsid core and membrane of viral particles have antigenic properties, which provides pathogens with high damaging ability.

Epidemiology of Epstein-Barr virus infection

The disease is slightly contagious (lowly contagious). Viruses infect both adults and children. Most often, EBVI occurs asymptomatically or in the form of acute respiratory infections. Children in the first 2 years of life are infected in 60% of cases. The proportion of people who have antibodies to viruses in their blood among adolescents is 50 - 90% in different countries, among adults - 95%.

Epidemic outbreaks of the disease occur once every 5 years. The disease is more often registered in children aged 1 - 5 years living in organized groups.

Source of infection

The Epstein-Barr virus enters the human body from patients with clinically pronounced and asymptomatic forms of the disease. Patients who have suffered an acute form of the disease remain dangerous to others for 1 to 18 months.

Pathways of pathogen transmission

The Epstein-Barr virus is spread by airborne droplets (with saliva), household contact (through household items, toys, oral sex, kissing and shaking hands), parenteral (through blood transfusion), sexual and vertical (from mother to fetus).

Entrance gate

The entry gate for the pathogen is the mucous membrane of the upper respiratory tract. Organs rich in lymphoid tissue - tonsils, spleen and liver - are primarily affected.

Rice. 3. Epstein-Barr virus is transmitted through saliva. The disease is often called the “kissing disease.”

How does the disease develop in adults and children?

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.

The pathogens persist (stay) in the human body for life and subsequently, with a decrease in the functioning of the immune system and hereditary predisposition, become the cause of the development of chronic Epstein-Barr virus infection and a number of severe oncological pathologies of a lymphoproliferative nature, autoimmune diseases and chronic fatigue syndrome.

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

In children and adults infected with Epstein-Barr viruses, pathological processes rarely develop, since the body's normal immune system is in most cases able to control and counteract the infection. Active reproduction of pathogens is caused by an acute bacterial or viral infection, vaccination, stress - everything that attacks the immune system.

Rice. 4. Epstein-Barr virus under a microscope.

EBVI classification

EBVI can be congenital (in children) and acquired (in children and adults).
Based on the form, they distinguish between typical (infectious mononucleosis) and atypical forms (asymptomatic, erased, visceral).
The infection can be mild, protracted or chronic.
The leading ones are intoxication, infectious (mononucleotide-like), gastrointestinal, cerebral, arthralgic and cardiac syndromes.

Acute form of Epstein-Barr virus infection in adults and children

Acute primary infection caused by Epstein-Barr viruses or mononucleosis-like syndrome (not to be confused with infectious mononucleosis) in adults and children begins with high fever, sore throat and enlarged posterior cervical lymph nodes. The anterior cervical and ulnar lymph nodes are somewhat less likely to enlarge. There are cases of generalized lymphadenopathy. In half of the patients the spleen is enlarged, in 10 - 30% of patients there is an enlargement of the liver. Some patients develop periorbital edema.

The incubation period for EBVI lasts 4 - 7 days. All symptoms are most pronounced on average by the 10th day of illness.

Symptoms of acute form of EBVI

Intoxication syndrome

Most cases of the disease begin acutely with high body temperature. Weakness, lethargy, malaise and loss of appetite are the main symptoms of EBVI during this period. Initially, the body temperature is subfebrile. After 2 - 4 days it rises to 39 - 40 0 C.

Generalized lymphadenopathy

Generalized lymphadenopathy is a pathogonic symptom of EBVI in adults and children. It appears from the first days of the disease. 5-6 groups of lymph nodes enlarge simultaneously: more often the posterior cervical ones, somewhat less frequently - the anterior cervical, submandibular and ulnar ones. In diameter from 1 to 3 cm, not soldered together, arranged either in chains or in packages. They are clearly visible when you turn your head. Sometimes pasty tissue is observed above them.

Rice. 5. Most often, with EBVI, the posterior cervical lymph nodes are enlarged. They are clearly visible when you turn your head.

Symptoms of tonsillitis in acute form of EBVI

Tonsillitis is the most common and early symptom of the disease in adults and children. Tonsils enlarge to II - III degree. Their surface becomes smoothed due to infiltration and lymphostasis with islands of dirty gray deposits, sometimes resembling lace, as in diphtheria, they are easily removed with a spatula, do not sink in water, and are easily rubbed. Sometimes plaques become fibrous-necrotic in nature and spread beyond the tonsils. Signs and symptoms of tonsillitis due to Epstein-Barr virus infection disappear after 5 to 10 days.

Rice. 6. Sore throat with EBVI. When plaque spreads beyond the tonsils, differential diagnosis should be made with diphtheria (photo on the right).

Symptoms of adenoiditis in acute form of EBVI

Adenoiditis in the disease is often recorded. Nasal congestion, difficulty breathing through the nose, snoring while sleeping with your mouth open are the main symptoms of Epstein-Barr virus infection in adults and children. The patient's face becomes puffy (takes on an “adenoid” appearance), the lips are dry, the eyelids and bridge of the nose are pasty.

Enlarged liver and spleen

When the disease occurs in children and adults, the liver enlarges already at the beginning of the disease, but most often in the 2nd week. Its size returns to normal within 6 months. Hepatitis develops in 15–20% of patients.

An enlarged spleen in adults and children is a later symptom of the disease. Its size returns to normal in 1 to 3 weeks.

Rash

Exanthema (rash) appears on days 4–14 of the disease. It's varied. It can be spotted, papular, roseolous, pinpoint or hemorrhagic, without a specific localization. Observed for 4 - 10 days. Often leaves behind pigmentation. The rash appears especially often in children receiving amoxicillin or ampicillin.

Hematological changes

In the acute form of EBVI, leukocytosis, neutropenia, lymphocytosis, and monocytosis are observed. Mononuclear cells appear in the blood in quantities from 10 to 50 - 80%. Mononuclear cells appear on the 7th day of illness and persist for 1 - 3 weeks. ESR rises to 20 - 30 mm/hour.

Rice. 7. Rash in children with Epstein-Barr virus infection.

Outcomes of acute form of EBVI in adults and children

There are several options for the outcome of the acute form of Epstein-Barr virus infection:

Recovery.
Asymptomatic virus carriers.
Chronic recurrent infection.
Development of cancer.
Development of autoimmune diseases.
The emergence of chronic fatigue syndrome.

Disease prognosis

The prognosis of the disease is influenced by a number of factors:

Degree of immune dysfunction.
Genetic predisposition to Epstein-Barr virus-associated diseases.
Acute bacterial or viral infection, vaccination, stress, surgery—anything that attacks the immune system—causes the active proliferation of pathogens.

Rice. 8. The photo shows infectious mononucleosis in adults. Enlarged lymph nodes are an important sign of the disease.

Infectious mononucleosis is a dangerous disease. At the first signs and symptoms of the disease, you should immediately consult a doctor.

Chronic Epstein-Barr virus infection in adults and children

The chronic form of the disease in adults and children has a variety of manifestations and course options, which makes diagnosis much more difficult. Chronic Epstein-Barr virus infection lasts a long time and has a relapsing course. Manifests itself as chronic mononucleosis-like syndrome, multiple organ failure, hemophagocytic syndrome. There are generalized and erased forms of the disease.

Chronic mononucleosis-like syndrome: signs and symptoms

Chronic mononucleosis-like syndrome in children and adults is characterized by a wave-like course, often described by patients as chronic influenza. Low-grade body temperature, weakness and malaise, muscle and joint pain, loss of appetite, discomfort in the throat, difficulty in nasal breathing, heaviness in the right hypochondrium, headaches and dizziness, depression and emotional lability, decreased memory, attention and intelligence - the main symptoms of the disease. Patients experience enlarged lymph nodes (generalized lymphadenopathy), enlarged liver and spleen. The palatine tonsils are enlarged (hypertrophied).

Hemophagocytic syndrome

Overproduction of anti-inflammatory cytokines by T cells infected with viruses leads to activation of the phagocyte system in the bone marrow, liver, peripheral blood, lymph nodes and spleen. Activated histiocytes and monocytes engulf blood cells. Anemia, pancytopenia and coagulopathy occur. The patient is worried about intermittent fever, hepatosplenomegaly, generalized lymphadenopathy is noted, and liver failure develops. Mortality reaches 35%.

Consequences of the development of immunodeficiency in adults and children

Decreased immunity leads to the development of many diseases of infectious and non-infectious nature. Conditionally pathogenic flora is activated. Viral, fungal and bacterial infections develop. Acute respiratory infections and other diseases of the ENT organs (rhinopharyngitis, adenoiditis, otitis, sinusitis, laryngotracheitis, bronchitis and pneumonia) are registered in patients up to 6 - 11 times a year.

In patients with a weakened immune system, the number of B-lymphocytes can increase to a huge number, which negatively affects the functioning of many internal organs: the respiratory and central nervous systems, heart, joints, biliary dyskinesia develops, and the gastrointestinal tract is affected.

Rice. 9. Lymphocytic infiltrates in the superficial layers of the epithelium of the mucous membrane of the intestinal crypts.

Generalized form of EBVI: signs and symptoms

With severe immune deficiency, patients develop a generalized form of EBVI. Damage to the central and peripheral nervous system is noted. Meningitis, encephalitis, cerebellar ataxia, and polyradiculoneuritis develop. Internal organs are affected - kidneys, heart, liver, lungs, joints. The disease often ends in the death of the patient.

Atypical forms of the disease

There are two forms of erased (latent, sluggish) or atypical forms of the disease.

In the first case, patients are bothered by prolonged low-grade fever of unknown origin, weakness, muscle-joint pain, and pain on palpation in the area of peripheral lymph nodes. The disease occurs in waves in adults and children.
In the second case, all the complaints described above are accompanied by symptoms indicating the development of secondary immunodeficiency: diseases of a viral, bacterial or fungal nature develop. There is damage to the respiratory tract, gastrointestinal tract, skin, and genital organs. The diseases last a long time and often recur. Their duration ranges from 6 months to 10 years or more. Viruses are found in blood lymphocytes and/or saliva.

Rice. 10. Rash due to infectious mononucleosis in children.

Asymptomatic virus carriers

The asymptomatic course is characterized by the absence of clinical and laboratory signs of the disease. Viral DNA is determined by PCR.

Diagnosis of the chronic form of Epstein-Barr virus infection

Chronic EBVI is characterized by a symptom complex that includes prolonged low-grade fever of unknown origin, decreased performance, unmotivated weakness, sore throat, enlarged peripheral lymph nodes, liver and spleen, liver dysfunction and mental disorders.

A characteristic feature is the lack of clinical effect from conventional therapy.

The anamnesis of such patients indicates prolonged excessive mental overload and stressful situations, a passion for fashionable diets and fasting.
A chronic course is indicated by:

infectious mononucleosis no more than six months ago or a disease occurring with high titers of IgM antibodies (to the capsid antigen);
histological examination (tissue examination) of organs involved in the pathological process (lymph nodes, liver, spleen, etc.);
an increase in the number of viruses in the affected tissues, proven by anti-complementary immunofluorescence with the nuclear antigen of the virus.

Viral activity is indicated by:

Relative and absolute lymphocytosis. Presence of atypical mononuclear cells in the blood. Somewhat less common are lymphopenia and monocytosis. In some cases, thrombocytosis and anemia.
Changes in immune status (decreased content and impaired function of natural killer cytotoxic lymphocytes, impaired humoral response).

Differential diagnosis of chronic EBVI

Chronic Epstein-Barr virus infection should be distinguished from viral diseases (viral hepatitis, cytomegalovirus infection, toxoplasmosis, etc.), rheumatic and oncological diseases.

Rice. 11. One of the symptoms of EBVI is a rash on the body of a child and an adult.

Virus-associated diseases

Viruses persist (stay) in the human body for life and subsequently, with a decrease in the functioning of the immune system and hereditary predisposition, become the cause of the development of a number of diseases: severe oncopathology, lymphoproliferative syndrome, autoimmune diseases and chronic fatigue syndrome.

Development of oncopathology

Infection of B-lymphocytes and disruption of their differentiation are the main causes of the development of malignant tumors and paraneoplastic processes: polyclonal lymphoma, nasopharyngeal carcinoma, leukoplakia of the tongue and oral mucosa, tumors of the stomach and intestines, uterus, salivary glands, lymphoma of the central nervous system, Burkitt's lymphoma, AIDS patients.

Development of autoimmune diseases

Epstein-Barr viruses play an important role in the development of autoimmune diseases: rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, vasculitis, ulcerative colitis.

Development of chronic fatigue syndrome

Epstein-Barr viruses play an important role in the development of chronic fatigue syndrome along with human herpes viruses types 6 and 7.

Some types of oncopathology and paraneoplastic processes

Burkitt's lymphoma

Burkitt's lymphoma is common in central Africa, where it was first described in 1958 by surgeon Denis Burkitt. It has been proven that the African variant of lymphoma is associated with the effect of viruses on B lymphocytes. When sporadic(“non-African”) lymphoma, the connection with the virus is less clear.

Most often, single or multiple malignant neoplasms are recorded in the jaw area, growing into adjacent tissues and organs. Young men and children get sick more often. In Russia, there are isolated cases of the disease.

Rice. 12. In the photo, Burkitt's lymphoma is one of the malignant tumors caused by the Epstein-Barr virus. This group includes cancer of the nasopharynx, tonsils, and many lymphomas of the central nervous system.

Rice. 13. Burkitt's lymphoma occurs mainly in children of the African continent aged 4 - 8 years. Most often the upper and lower jaws, lymph nodes, kidneys and adrenal glands are affected.

Rice. 14. T-cell lymphoma of the nasal type. The disease is common in Central and South America, Mexico and Asia. This type of lymphoma is especially often associated with the Epstein-Barr virus in Asian populations.

Nasopharyngeal carcinoma

Rice. 15. The photo shows enlarged lymph nodes with nasopharyngeal carcinoma in an HIV-infected person.

Kaposi's sarcoma

This is a malignant multifocal tumor of vascular origin that affects the skin, mucous membranes and internal organs. It has several varieties, one of which is epidemic sarcoma associated with AIDS.

Rice. 16. Kaposi's sarcoma in patients with AIDS.

Leukoplakia of the tongue

In some cases, the cause of the disease is the Epstein-Barr virus, which multiplies in the epithelial cells of the oral cavity and tongue. Gray or white plaques appear on the tongue, gums, cheeks and palate. They are fully formed within a few weeks or even months. As the plaques harden, they take the form of thickened areas that rise above the surface of the mucous membrane. The disease is often reported in HIV-infected patients.

Rice. 17. The photo shows hairy leukoplakia of the tongue.

Autoimmune diseases

The Epstein-Barr virus contributes to the development of autoimmune diseases - systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, vasculitis, ulcerative colitis.

Rice. 18. Systemic lupus erythematosus.

Rice. 19. Systemic lupus erythematosus and rheumatoid arthritis.

Rice. 20. Sjogren's syndrome is an autoimmune disease. Dry eyes and dry mouth are the main symptoms of the disease. The disease is often caused by the Epstein-Barr virus.

Congenital Epstein-Barr virus infection

Congenital Epstein-Barr virus infection is recorded in 67% of cases of acute form of the disease and in 22% of cases when the chronic course of the infection is activated in women during pregnancy. Newborns are born with pathologies of the respiratory, cardiovascular and nervous systems, and their own antibodies and the mother’s antibodies can be detected in their blood. The pregnancy period can be interrupted by miscarriages or premature births. Children born with immunodeficiency die from proliferative syndrome as soon as possible after birth.

Diagnosis of the disease

When diagnosing Epstein-Barr virus infection, the following laboratory research methods are used:

General clinical studies.
Study of the patient's immune status.
DNA diagnostics.
Serological studies.
Study of various materials in dynamics.

Clinical blood test

During the study, an increase in the number of leukocytes, lymphocytes and monocytes with atypical mononuclear cells, hemolytic or autoimmune anemia, a decrease or increase in the number of platelets is observed.

In severe cases, the number of lymphocytes increases significantly. From 20 to 40% of lymphocytes acquire an atypical shape. Atypical lymphocytes (mononuclear cells) remain in the patient’s body from several months to several years after infectious mononucleosis.

Rice. 21. In the photo there are atypical lymphocytes - mononuclear cells. They are always detected in blood tests for Epstein-Barr virus infections.

Blood chemistry

There is an increase in the level of transaminases, enzymes, C-reactive protein, and fibrinogen.

Clinical and biochemical indicators are not strictly specific. Changes are also detected in other viral diseases.

Immunological studies

Immunological studies for the disease are aimed at studying the state of the interferon system, the level of immunoglobulins, the content of cytotoxic lymphocytes (CD8+) and T-helper cells (CD4+).

Serological studies

Epstein-Barr virus antigens are formed sequentially (surface → early → nuclear → membrane, etc.) and antibodies to them are also sequentially formed, which makes it possible to diagnose the disease and determine the duration of infection. Antibodies to the virus are determined by ELISA (enzyme-linked immunosorbent assay).

The production of antigens by Epstein-Barr viruses occurs in a certain sequence: surface → early → nuclear → membrane, etc.

Specific IgM in the patient’s body appears during the acute period of the disease or during exacerbations. Disappears after 4 - 6 weeks.
Specific IgG to EA (“early”) also appears in the patient’s body during the acute period and decreases during recovery within 3–6 months.
Specific IgG to VCA (“early”) also appears in the patient’s body during the acute period. Their maximum is recorded at 2–4 weeks and then decreases, but the threshold level remains for a long time.
IgG to EBNA is detected 2-4 months after the end of the acute phase and is subsequently produced throughout life.

Polymerase chain reaction (PCR)

Using PCR for disease, Epstein-Barr viruses are detected in various biological materials: blood serum, saliva, lymphocytes and peripheral blood leukocytes. If necessary, biopaths of the liver, intestinal mucosa, lymph nodes, scrapings of the oral mucosa and urogenital tract, prostate secretions, cerebrospinal fluid, etc. are examined. The sensitivity of the method reaches 100%.

Differential diagnosis

Diseases with a similar clinical picture include:

HIV infection and AIDS,
anginal (painful) form of listeriosis,
measles,
viral hepatitis,
(CMVI),
localized diphtheria of the throat,
angina,
adenovirus infection,
blood diseases, etc.

The fundamental criteria for differential diagnosis are changes in the clinical blood test and serological diagnosis.

Rice. 22. Enlarged lymph nodes in children with infectious mononucleosis.

Treatment of Epstein-Barr virus infection in adults and children

Before starting treatment for Epstein-Barr virus infection, it is recommended to examine all members of the patient’s family in order to detect the release of pathogens in saliva. If necessary, they receive antiviral therapy.

Treatment of EBVI in adults and children during the period of acute manifestation of primary infection

During the period of acute manifestation of primary infection, special treatment for Epstein-Barr virus infection is not required. However, with prolonged fever, severe manifestations of tonsillitis and tonsillitis, enlarged lymph nodes, jaundice, increasing cough and the appearance of abdominal pain, hospitalization of the patient is necessary.

In cases of mild to moderate severity of the disease, the patient is recommended to follow a general regimen at an adequate energy level. Prolonged bed rest prolongs the healing process.

Analgesics are used to reduce pain and inflammation. Drugs from the group of non-narcotic analgesics have proven themselves well: Paracetamol and its analogues, Ibuprofen and its analogues.

Rice. 23. In the photo on the left is the drug for pain relief Tylenol (the active ingredient is paracetamol. In the photo on the right is the drug Advil (the active ingredient is ibuprofen).

If there is a threat of developing a secondary infection or if there is discomfort in the throat, medications are used that include antiseptics, disinfectants and analgesics.

It is convenient to treat diseases of the oropharynx with combination drugs. They contain antiseptics and disinfectants with antibacterial, antifungal, and antiviral effects, painkillers, vegetable oils and vitamins.

Combined preparations for topical use are available in the form of sprays, rinses and lozenges. The use of drugs such as Hexetidine, Stopangin, Hexoral, Tantum Verde, Yox, Miramistin is indicated.

For sore throat, the use of drugs such as TeraFlu LAR, Strepsils Plus, Strepsils Intensive, Flurbiprofen, Tantum Verde, Anti-Angin Formula, Neo-angin, Kameton - aerosol is indicated. Local preparations containing analgesic components cannot be used in children under 3 years of age due to the risk of developing laryngospasm.

Local treatment with antiseptics and disinfectants is indicated in case of secondary infection. In infectious mononucleosis, tonsillitis is aseptic.

Treatment of EBVI in adults and children with chronic disease

Treatment of Epstein-Barr virus infection is based on an individual approach to each patient, taking into account the course of the disease, its complications and immune status. Treatment of chronic EBVI should be comprehensive: etiotropic (aimed primarily at the destruction of viruses), continuous and long-term, observing the continuity of treatment measures in inpatient, outpatient and rehabilitation settings. Treatment should be carried out under the control of clinical and laboratory parameters.

Basic therapy

The basis of treatment for EBVI is antiviral drugs. At the same time, the patient is recommended a protective regime and dietary nutrition. Treatment of infection with other drugs is additional.

The following antiviral drugs are used:

Isoprinosine (Inosine pranobex).
Acyclovir and Valtrex (abnormal nucleosides).
Arbidol.
Interferon preparations: Viferon (recombinant IFN α-2β), Reaferon-ES-Lipint, Kipferon, interferons for intramuscular administration (Realdiron, Reaferon-EC, Roferon A, Intron A, etc.).
IFN inducers: Amiksin, Anaferon, Neovir, Cycloferon.

Long-term use of Viferon and Inosine pranobex potentiates the immunocorrective and antiviral effects, which significantly increases the effectiveness of treatment.

Immunocorrective therapy

When treating EBVI, the following are used:

Immunomodulators Lykopid, Polyoxidonium, IRS-19, Ribomunil, Derinat, Imudon, etc.
Cytokines Leukinferon and Roncoleukin. They contribute to the creation of antiviral readiness in healthy cells, suppress the reproduction of viruses, and stimulate the work of natural killer cells and phagocytes.
Immunoglobulins Gabriglobin, Immunovenin, Pentaglobin, Intraglobin, etc. Drugs in this group are prescribed in cases of severe Epstein-Barr virus infection. They block “free” viruses that are found in the blood, lymph and intercellular fluid.
Thymus preparations ( Timogen, Immunofan, Taktivin etc.) have a T-activating effect and the ability to stimulate phagocytosis.

Treatment of Epstein-Barr virus infection with corrector drugs and immune stimulants is carried out only after an immunological examination of the patient and a study of his immune status.

Symptomatic remedies

For fever, antipyretic drugs Ibuprofen, Paracetamol, etc. are used.
If nasal breathing is difficult, nasal medications Polydexa, Isofra, Vibrocil, Nazivin, Adrianol, etc. are used.
For dry cough in adults and children, Glauvent, Libexin, etc. are recommended.
For wet cough, mucolytics and expectorants are prescribed (Bromhexal, Ambro HEXAL, Acetylcysteine, etc.

Antibacterial and antifungal drugs

In case of secondary infection, antibacterial drugs are prescribed. With Epstein-Barr virus infections, streptococci, staphylococci, and Candida fungi are more often found. The drugs of choice are 2nd - 3rd generation cephalosporins, macrolides, carbapenems and antifungal drugs. For mixed microflora, the drug metronidazole is indicated. Antibacterial drugs such as Stopangin, Lizobakt, Bioparox, etc. are used locally.

Means of pathogenetic therapy

Metabolic rehabilitation drugs: Elkar, Solcoseryl, Actovegin, etc.
To normalize the functioning of the gastrointestinal tract, hepatoprotectors (Galstena, Hofitol, etc.), enterosorbents (Filtrum, Smecta, Polyphepan, Enterosgel, etc.), probiotics (Acipol, Bifiform, etc.) are used.
Angio- and neuroprotectors (Gliatilin, Instenon, Encephabol, etc.).
Cardiotropic drugs (Cocarboxylase, Cytochrome C, Riboxin, etc.).
Antihistamines of the 1st and 3rd generations (Fenistil, Zyrtec, Claritin, etc.).
Protease inhibitors (Gordox, Kontrikal).
Hormonal drugs prednisolone, hydrocortisone and dexamethasone are prescribed for severe infection - airway obstruction, neurological and hematological complications. Drugs in this group reduce inflammation and protect organs from damage.
Detoxification therapy is carried out when the disease becomes severe and is complicated by a ruptured spleen.
Vitamin and mineral complexes: Vibovit, Multi-tabs, Sanasol, Biovital gel, Kinder, etc.
Antihomotoxic and homeopathic remedies: Aflubin, Oscillococcinum, Tonzilla compositum, Lymphomyosot, etc.
Non-drug treatment methods (magnetic therapy, laser therapy, magnetotherapy, acupuncture, physical therapy, massage, etc.
When treating asthenic syndrome, adaptogens, high doses of B vitamins, nootropics, antidepressants, psychostimulants and cell metabolism correctors are used.

Rehabilitation of children and adolescents

Children and adults who have suffered EBVI need long-term rehabilitation. The child is removed from the register six months to a year after clinical and laboratory parameters are normalized. Examination by a pediatrician is carried out once a month. If necessary, the child is referred to a consultation with an ENT doctor, hematologist, immunologist, oncologist, etc.

Laboratory examination methods used:

General blood test once a month for 3 months.
ELISA once every 3 months.
PCR according to indications.
Throat swab once every 3 months.
Immunogram once every 3-6 months.
Biochemical studies are carried out according to indications.

Complex therapy and an individual approach when choosing patient management tactics, both at home and in a hospital setting, are the key to successful treatment of Epstein-Barr virus infection.

Articles in the section "Herpes infections"Most popular

Professor Michael Epstein and his graduate student Yvonne Barr described a virus relatively recently - in 1964 - which was given a double name after their last names - Epstein-Barr. Despite the fact that this is one of the most common microorganisms of the herpes species, it is still “overlooked” by attention.

Danger of Epstein-Barr virus

This microorganism was isolated from biopsies of lymphoma tumors taken from children from African countries.

The difference between this virus and its “brothers” is that it encodes 85 proteins. For comparison: the herpes simplex virus encodes only 20. The virus attaches to the cell using a special structure - on its surface there is a large number of glycoproteins that ensure reliable penetration into the mucous membrane.

Once the virus enters the body, it remains for life and infects 90% of the human population. It is transmitted through contacts, during operations - through blood and bone marrow - and by airborne droplets.

But in most cases, the Epstein-Barr virus is transmitted to children through kisses from infected adults. The danger of this pathogenic flora does not lie in its penetration into the body, but in the fact that it provokes malignant processes and causes diseases that can cause serious complications in people with a reduced immune status. One of the diseases that occurs when the Epstein-Barr virus is introduced is infectious mononucleosis or Filatov's disease.

An increase in its activity causes the following diseases:

chronic fatigue syndrome;
systemic hepatitis;
lymphogranulomatosis;
lymphomas;
multiple sclerosis;
hairy leukoplakia of the oral cavity and some others.

Epstein-Barr symptoms

The characteristic symptoms of the Epstein-Barr virus depend on the disease that it provoked, but general signs indicate its introduction.

For example, infectious mononucleosis causes the following symptoms:

increased fatigue;
signs of pharyngitis;
temperature rise above febrile – more than 39º;
by days 5-7, the lymph nodes enlarge, starting with the cervical ones;
the spleen increases in size, sometimes the liver;
urine darkens;
the rash is heterogeneous in nature - urticaria, papules with liquid, roseola appear simultaneously.

Similar symptoms occur with chronic infection of the Epstein-Barr virus, the only thing is that during it the function of nasal breathing is impaired and mental abilities are reduced.

Against the background of the disease caused by this virus, the introduction of pathogenic flora of a different type begins and secondary infection occurs, candidiasis, stomatitis, inflammatory diseases of the upper and lower respiratory tract and digestive organs may begin.

Consequences of the EPSTEIN-BARR VIRUS

Infectious mononucleosis can be mild or severe; in some cases, it goes away without treatment after 4 months.

But the introduction of the virus sometimes causes severe complications that appear after the disease:

encephalitis and meningitis;
obstruction of the bronchopulmonary tree;
general damage to the nervous system
hepatitis;
damage to the cranial nerves;
pericarditis;
myocarditis.

These diseases occur more often in children, since adults suffered from mononucleosis in childhood. In whatever form the diseases caused by the introduction of the virus occur.

Epstein-Barr - acute or chronic - they need to be treated. This is the only way to avoid complications.

Diagnosis of EPSTEIN-BARR VIRUS

To detect the Epstein-Barr virus in the body, the following laboratory diagnostic tests are used.

In a general blood test, the number of leukocytes, monocytes and lymphocytes is calculated - if infected, their number exceeds the norm;
Biochemical analysis - enzyme indicators AST, LDH and ALT are increased;
The state of the immune system is assessed: the production of interferon, immunoglobulins, etc. is specified;
Serological diagnostics are carried out - in time it detects antibodies to the Epstein-Barr virus. IgM titers are determined. They are elevated during the clinical picture caused by mononucleosis, but also remain high after recovery - immunity against this virus lasts for life;
During DNA diagnostics, it is determined whether there are antibodies in physiological fluids: saliva, smears from the upper respiratory tract, spinal cord;
With the culture method, the spread of the virus is established - it is grown on brain cells, cells of patients with leukemia, etc.

Research allows not only to find viral particles in the blood, but also to determine the degree of damage to the body and predict the risk of complications.

Treatment of Epstein-Barr virus

There is no specific scheme according to which treatment is carried out. Each case requires its own therapeutic approach.

All patients suspected of infectious mononucleosis must be hospitalized.

bed rest;
increasing the amount of fluid you drink - drinks should be warm;
respiratory manifestations are relieved with vasoconstrictor drops and rinses - solutions with antiseptics and folk remedies;
decrease in temperature;
vitamin therapy;
antihistamines.

Therapy begins with the use of antiviral drugs of different groups: Arbidol, Valtrex, Acyclovir, interferons.

Antibiotics are included in therapeutic measures more often when a secondary infection occurs or respiratory conditions of acute severity.

Immunoglobulins used against the Epstein-Barr virus are one of the main drugs that help avoid complications after diseases caused by the introduction of this pathogenic flora. Immunoglobulin is administered by injection intravenously. The therapy is supplemented with drugs that increase the immune status of the body - immunomodulators and biological stimulants: Derinat, Likopid, cytokines, Actovegin...

If additional symptoms occur, they are eliminated according to individual schemes. The temperature is reduced with conventional antipyretics, mucolytics and antitussives are prescribed for coughs, otitis media is treated with special drops, and a runny nose is treated with local vasoconstrictor medications.

The duration of the disease varies from 2-3 weeks to 3-4 months, it all depends on the severity of the symptoms.

Preventative measures for EPSTEIN-BARR VIRUS

It is impossible to prevent the introduction of the Epstein-Barr virus; it is necessary to try to create conditions so that the child’s body can endure the “meeting” with it as easily as possible and subsequently develop immunity for life. Children with normal immune status tolerate mononucleosis normally - it can even be asymptomatic.

The study of the Epstein-Barr virus in recent years has radically changed the understanding of everything related to health. It completely torments the human body, causing a variety of and sometimes unrelated pathologies.

It turned out that the Epstein-Barr virus, one of those diseases that no one had previously considered diseases, causes significant harm to humans, and is also the root cause and trigger of many unpleasant and even dangerous health problems.

This infection cannot be completely eradicated and continues to ruin a person’s life from the moment it enters the body, causing the most unpredictable consequences. According to statistics, the Epstein-Barr virus lives in the bodies of 60% of children under 5 years of age and in almost 100% of the adult population of planet Earth.

What kind of disease is this?

This virus is from the herpetic family, namely herpes type 4. The Epstein-Barr virus attacks the immune system, the central nervous system, as well as all human systems and organs.

Penetrating through the mucous membranes of the mouth and nose, it enters the bloodstream and spreads throughout the body. That is why EBV has many faces and can have various manifestations, ranging from mild illness to extremely serious health problems.

There are cases when a carrier of the Epstein-Barr virus never suffers from its manifestations. Many famous doctors consider it the culprit of all existing diseases among humanity.

In the medical literature, for better visual perception, the Epstein-Barr virus is designated by the abbreviation VEB or WEB.

Prevalence of the disease

WEB is one of the most common viruses in the world among the population. According to WHO (World Health Organization) statistics, 9 out of 10 people are carriers of this herpetic infection.

Despite this, its research began only recently, so it cannot be said that it has been sufficiently studied. Children are often infected with EBV in utero or in the first few months after birth.

Recent studies show that it is the Epstein-Barr virus that is the provoking factor for other pathologies that cannot be completely cured.

Namely:

Rheumatoid polyarthritis;
Autoimmune thyroidin;
Diabetes mellitus.

However, the infection does not lead to diseases on its own, but through interaction with other viral lesions.

If a person is susceptible to chronic fatigue syndrome and it seems to him that he is not getting enough sleep, there is a lack of vitamins in the body or a reaction to weather conditions, then it is possible that the Epstein-Barr virus provokes all of the above symptoms.

Often it is the cause of the decline in vitality.

Routes of infection

Sources of EBV infection are:

Those in whom it has been present in active form since the last days of the incubation period;
People who became infected with the virus more than six months ago;
Any carrier of the virus is a potential source of infection for everyone with whom he comes into contact.

The most vulnerable categories for potential infection are:

Women during pregnancy;
HIV positive;
Children under 10 years of age.

WEB transmission paths:

How does infection occur in adults?

Stages of infection:

Symptoms of the disease

Most often, people become infected with EBV early in life (childhood or adolescence), since it has many routes of infection through contact with an infected person.

In adults, the Epstein-Barr virus is reactivated and does not cause acute symptoms.

Symptoms of primary infection:

The chronic course of the Epstein-Barr virus is characterized by prolonged manifestation of symptoms of various types and levels of intensity.

Namely:

Fatigue and general weakness;
Heavy sweating;
Difficulty in nasal breathing;
Pain in joints and muscles;
Periodic mild cough;
Constant headaches;
Aching pain in the right hypochondrium;
Mental disorders, emotional instability, depressive states, poor concentration and memory loss;
Sleep disorders;
Inflammatory diseases of the respiratory tract and gastrointestinal disorders.

Photos of virus manifestations:

Why is Epstein-Barr virus dangerous in adults?

With a single infection, Epstein-Barr remains in the human body forever. In good health, the course of the infection has no obvious symptoms or minimal symptoms.

When the immune system of an infected person is weakened by other factors, then, as a rule, the Epstein-Barr virus affects the following organs and systems:

Mucous membranes of the upper respiratory tract and ENT organs;
Epithelial cells;
Nerve fibers;
Macrophages;
NK cells;
T lymphocytes.

The Epstein-Barr virus is extremely dangerous for HIV-positive people. Infection with it can be fatal for them.

What diseases can the Epstein-Barr virus cause in adults?

Complicated consequences:

Development of oncopathologies:

Lymphoma;
Lymphogranuloma;
Cancer of the tonsils, neoplasms of the ENT organs;
Gastrointestinal cancer.

Epstein-Barr cells are found in most biopsy specimens along with malignant cells. It is not the main cause of cancer, but acts as a provoking factor along with other pathologies.

Autoimmune system diseases:

Diabetes;
Multiple sclerosis;
Arthritis.

The Epstein-Barr virus, along with other cell-damaging viruses, leads to impaired immune response. The immune system perceives its own cells as enemy cells and begins to attack them, thus damaging them.

Immunity disorders:

Diseases of the circulatory system:

Among other things, the presence of EBV can provoke the development of bacterial and fungal diseases. As well as damage to the central nervous system and a decrease in the overall tone of the body, as a result of which chronic fatigue syndrome develops.

Diagnostic measures

If EBV infection is suspected, the patient consults a general practitioner, who conducts a face-to-face examination and analyzes the patient’s complaints.

Research methods to detect Epstein-Barr virus:

ELISA— allows you to determine the presence of antibodies to various Epstein-Barr antigens, this helps to identify the form of infection: chronic, acute, asymptomatic;
PCR— using this method it is possible to find out whether a person has the virus. It is used for children whose immature immune systems do not produce antibodies to EBV. This method is also used for clarifying purposes when the ELISA result is questionable.

Explanation of PCR tests:

The main criterion makes it possible to find out about the presence of a virus in the body;
The result can be positive or negative;
Moreover, a positive result does not in any way indicate the presence of an acute or chronic process, despite the presence of EBV in a person;
A positive test result means that the patient has already been infected with EBV;
If the analysis is negative, we can say with confidence that EBV has never entered the human body.

Interpretation of ELISA tests:

Regarding all antigens, ELISA, in addition to a positive or negative result, is still doubtful;
In case of a doubtful result, the analysis must be retaken after 7-10 days;
If the result is positive, the Epstein-Barr virus is present in the body;
Based on the results, which antigens are identified, one can judge the stage of infection (asymptomatic, chronic, acute).

This test allows you to determine the presence of an antigen in the human body:

IgG to VCA capsid antigen— in case of a negative result, the human body has never encountered EBV. But there may be the presence of EBV cells in the body if the infection occurred 10 to 15 days ago. A positive result indicates the presence of the virus in a person. But he cannot talk about what stage the infection is at or when exactly the infection occurred. Results:
- from 0.9 to 1 - the analysis needs to be retaken;
gG to nuclear antigen EBNA- if the result is positive, the person is immune to EBV, but this does not indicate a chronic course of the infection; if the test is negative, a virus of this type has never entered the patient’s body. Results:
- up to 0.8 - the result is negative;
- from 1.1 - the result is positive;
- from 0.9 to 1 - the analysis requires a retake;
IgG to early antigen EA- in the case when IgG to the nuclear antigen anti-lgG-NA is negative, then the infection occurred recently and is a primary infection. Results:
- up to 0.8 - the result is negative;
- from 1.1 - the result is positive;
- 0.9 -1 - analysis requires a retake;
lgM to VCA capsid antigen- if the result is positive, we are talking about recent infection (up to three months), as well as reactivation of the infection in the body. A positive indicator of this antigen can be present from 3 months to a year. A near-positive anti-IgM-VCA may also indicate chronic infection. In the acute course of Epstein-Barr, this analysis is looked at over time so that one can judge the adequacy of treatment. Results:
- up to 0.8 - the result is negative;
- from 1.1 and above - the result is positive;
- from 0.9 to 1 - the analysis requires a retake.

Decoding the analysis on VEB

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	-/+	+++	++++	-/+

Treatment methods

EBV, like others, cannot be completely cured. EBV cells remain in the body for life, and their influence is controlled by the immune system. When immunity decreases, the virus becomes active.

General principles of treatment

These include the following basic principles:

Infectious activity is blocked by antiviral drugs and stimulation of the body's overall resistance. With all its capabilities, even modern medicine cannot help kill all Epstein-Barr virus cells, or completely remove them from the body;
Infectious mononucleosis being treated in a hospital setting or at home under the supervision of a specialist;
Additionally, the patient is prescribed bed rest and a balanced diet. with limited physical activity. The patient is recommended to drink plenty of fluids, include fermented milk products in the diet, and eat a diet with sufficient protein content. Elimination of products that can cause allergic reactions;
Chronic fatigue syndrome will help neutralize:
- Maintaining sleep and rest patterns;
- Balanced diet;
- Vitamin complexes;
- Moderate physical activity;
Drug treatment for EBV is comprehensive and aimed at strengthening the immune system., relieving symptomatic manifestations, reducing their aggressiveness. It also includes preventive measures to prevent complications.

Drug treatment

The following drugs may be prescribed for drug therapy.

Immunostimulating drugs — drugs are used during periods of exacerbation of EBV and for recovery after infectious mononucleosis:

Arbidol;
Viferon;
Interferon;
Groprinasine;
Laferobion.

Antiviral drugs - used in the treatment of complications caused by EBV:

Gerpevir;
Valvir;
Valtrex.

Antibacterial drugs— prescribed in cases of complications with bacterial infections, such as pneumonia, etc. Any antibacterial drugs can be used, except penicillins.

For example:

Cefodox;
Lincomycin;
Azithromycin;
Ceftriaxone.

Vitamin complexes are used for recovery after the acute stage of EBV, as well as for the prevention of complications:

Duovit;
Complivit;
Vitrum.

Sorbents are needed to alleviate the manifestations of infectious mononucleosis. Promotes the removal of toxic substances:

White coal;
Atoxyl;
Polysorb;
Enterosgel.

Supportive drugs for the liver (hepatoprotectors) - help support the liver after an acute period of EBV:

Karsil;
Essentiale;
Gepabene;
Darsil.

— used to prevent complications that EBV can cause:

Ketotifen;
Cetrin;
Eden;
Suprastin;
Diazolin.

Means for treating the oral cavity - used in preventive measures for sanitation of the oral cavity:

Decathylene;
Inglalipt;
Chlorophyllipt.

Anti-inflammatory - relieve symptoms of fever and general symptoms of malaise:

Paracetamol;
Nurofen;
Ibuprofen;
Nimesulide.

The exception is Aspirin.

Glucocorticosteroids - help fight severe complications:

Dexamethosone;
Prednisolone.

Drug treatment is prescribed by the attending physician on a strictly individual basis in each specific case. Uncontrolled use of medications can be not only useless, but also dangerous.

To combat chronic fatigue, which is caused by the presence of the Epstein-Barr virus in the body, the patient is prescribed treatment consisting of:

Multivitamins;
Antidepressants;
Antiherpetic drugs;
Cardiovascular;
Drugs supporting the nervous system:
- Instenon;
- Enciphabol;
- Glycine.

Traditional methods of treatment

Folk remedies have a good effect in the fight against many diseases, the Epstein-Barr virus is no exception. Traditional methods perfectly complement traditional methods of treatment for the acute course of the virus and infectious mononucleosis.

They are aimed at strengthening general immune qualities, relieving inflammation and avoiding exacerbation of the disease.

Echinacea:

Echinacea infusion perfectly strengthens the immune system and helps avoid exacerbations;
It should be consumed daily, 20 drops per glass of water.

Green tea:

Ginseng tincture:

Ginseng tincture is simply a storehouse for the protective forces of the human body;
It should be added to tea, about 15 drops per glass of drink.

Consequences of Epstein-Barr virus during pregnancy

In case of pregnancy planning, in preparation, future parents are prescribed a number of tests.

In this case, special attention is paid to infections.

They can influence conception, the course of pregnancy and its favorable completion with the birth of a healthy child.

Among such infections, EBV occupies quite a significant role.

It belongs to the “TORCH” series:

T - toxoplasmosis;
O - others: listeriosis, chlamydia, measles, syphilis, hepatitis B and C, HIV;
R - (rubella);
C - cytomegalovirus;
H - herpes (herpes simplex virus).

Infection with any of the TORCH infections during pregnancy can be disastrous for the child, causing serious health problems, deformities and pathologies incompatible with life.

That is why undergoing this analysis, through an unpleasant procedure - taking blood from a vein, is mandatory. Timely therapy and constant monitoring by specialists can minimize risks to the health of the fetus.

Such an analysis for the expectant mother is carried out not only during planning, but also twice during the gestation period, namely at 12 and 30 weeks.

Based on the results of the analyses, it is customary to draw conclusions regarding the following points:

In the absence of antibodies to EBV in the blood you need to be actively monitored and protect yourself as much as possible from possible infection;
In the presence of positive immunoglobulins class M with the birth of a child, it is necessary to wait until antibodies to this type of virus are developed;
Blood contains immunoglobulins class G- this means the presence of antibodies in the body of the expectant mother, which means that her immunity will protect the baby as much as possible.

When the Epstein-Barr virus is detected in an active acute form in a pregnant woman, this requires urgent hospitalization and hospital treatment under the supervision of specialists.

The measures are aimed at neutralizing symptoms and supporting the immune system of the expectant mother by administering antiviral medications and immunoglobulins.

It is impossible to say for sure exactly how EBV will affect the course of pregnancy and the health of the fetus. However, it is reliably known that babies whose mothers carry an active form of the Epstein-Barr virus during pregnancy often develop developmental defects.

At the same time, its presence in a woman’s body in primary or acute form does not exclude the birth of a healthy child, and its absence does not guarantee.

Possible consequences of EBV infection during pregnancy:

Miscarriages and stillbirths;
Premature birth;
Developmental delay (IUGR);
Complications during childbirth: sepsis, uterine bleeding, DIC syndrome;
Disturbances in the development of the baby's central nervous system. This is due to the fact that EBV affects nerve cells.

Prognosis of the patient

As a rule, the entry of the Epstein-Barr virus into the body system is accompanied by various symptoms, from mild illness to more serious manifestations.

With proper and adequate treatment and a normal state of the immune system, this virus does not cause significant damage to the body and does not interfere with a person’s normal life.

Prevention measures

Given the prevalence of EBV and the ease of its transmission, it is extremely difficult to protect yourself from infection.

Doctors around the world are faced with the task of inventing prophylactic agents to combat this virus, since it is a provoking factor in the development of cancer and other dangerous diseases.

Many scientific research centers are now conducting clinical trials on this issue. It is impossible to protect yourself from infection, but you can get by with minimal consequences if you have a strong body.

Therefore, EBV prevention measures are aimed at generally strengthening the protective functions of the human body:

The Epstein-Barr virus was discovered relatively recently, in 1964, and belongs to the herpesvirus family, subfamily gamma. Interestingly, Epstein Barr virus can cause several diseases.

The source of infection is a person, and it does not matter whether he currently has signs of illness or not.

Infectious mononucleosis or, as it is also called, the kissing disease. Infection is typical among children and young people (up to 40 years of age). The virus is transmitted in the following ways:

Through saliva (during kissing or oral sex);

When shaking hands;

When sharing toys and household items;

By blood transfusion.

The prevalence of Epstein Barr virus carriers is very high, reaching 95% of people over 35 years of age in the United States. Children, as a rule, become infected from their mothers; in developing countries, half of children under 5 years of age are infected with this virus. If the infection occurred at an early age, then, as a rule, the picture of the disease is rather “blurred” and can be regarded as another disease. Due to its prevalence, let's talk about it on our website www.site in the article “Epstein Barr Virus: symptoms, diagnosis, consequences.”

The Epstein-Barr virus is characterized by an incubation period that lasts 30-60 days, then the pathogen is fully activated and begins to multiply in the cells of the surface layers of the mucous membranes of the nose, pharynx and lymph nodes.

Epstein Barr virus has the following symptoms:

An increase in temperature to 38-40C, accompanied by chills;

Headache;

Severe weakness, malaise, loss of appetite;

Sore throat, especially when swallowing;

Sweating;

Sometimes a pinpoint rash appears on the body

Gradually, the Epstein-Barr virus enters the blood and spreads throughout the body. This is accompanied by enlarged lymph nodes. Typically the virus is found in the spleen, salivary glands, lymph nodes of any group, cervix, and liver.

Infectious mononucleosis is characterized by enlargement of the submandibular, cervical, and postauricular lymph nodes. Sore throat lasts about a week.

In a sick person, under the influence of the virus, the number of leukocytes - “white blood cells” - decreases, which can be detected in a blood test of the sick person.

If a person has an immunodeficiency (for example, with AIDS), then an enlargement of the liver and spleen is likely, accompanied by jaundice.

Infectious mononucleosis goes away on its own within one to two months, sometimes even earlier.

Consequences of the Epstein Barr virus

Complications of infectious mononucleosis are quite rare, but you should always keep in mind the likelihood of their occurrence:

A rupture of the spleen is very dangerous, even leading to death;

Changes in blood composition (decrease in red blood cells, platelets, leukocytes);

Lesions of the nervous system – encephalitis, convulsive syndrome, cerebellar disorders;

Inflammation of the heart muscle - myocarditis, the lining of the heart - pericarditis.

Diagnosis of Epstein Barr virus

The diagnosis is made based on characteristic symptoms and a study of the level of antibodies in the patient’s blood to the Epstein-Barr virus.

No connection has been identified between infectious mononucleosis and the development of tumor processes.

Another disease caused by a virus is Burkitt's lymphoma. This is a tumor process that affects the lymph nodes, upper or lower jaw, kidneys, and ovaries. This disease occurs only in Africa in children aged four to eight years.

The diagnosis is made based on the detection of the virus in lymphoblasts and lymph nodes.

Also, the Epstein-Barr virus can contribute to the development of lymphogranulomatosis and malignant tumors of the nasopharynx.

As a rule, tumor processes develop under the influence of a virus quite rarely, usually due to genetic predisposition or immunodeficiency.