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Annu Rev Immunol. 2015;33:787-821. doi: 10.1146/annurev-immunol-032414-112326. Epub 2015 Feb 11.

The immunology of Epstein-Barr virus-induced disease.

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1
School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; email: g.s.taylor@bham.ac.uk , h.m.long@bham.ac.uk , j.m.brooks@bham.ac.uk , a.b.rickinson@bham.ac.uk , a.d.hislop@bham.ac.uk.

Abstract

Epstein-Barr virus (EBV) is usually acquired silently early in life and carried thereafter as an asymptomatic infection of the B lymphoid system. However, many circumstances disturb the delicate EBV-host balance and cause the virus to display its pathogenic potential. Thus, primary infection in adolescence can manifest as infectious mononucleosis (IM), as a fatal illness that magnifies the immunopathology of IM in boys with the X-linked lymphoproliferative disease trait, and as a chronic active disease leading to life-threatening hemophagocytosis in rare cases of T or natural killer (NK) cell infection. Patients with primary immunodeficiencies affecting the NK and/or T cell systems, as well as immunosuppressed transplant recipients, handle EBV infections poorly, and many are at increased risk of virus-driven B-lymphoproliferative disease. By contrast, a range of other EBV-positive malignancies of lymphoid or epithelial origin arise in individuals with seemingly intact immune systems through mechanisms that remain to be understood.

KEYWORDS:

adaptive immunity; autoimmunity; immunodeficiency; immunotherapy; innate immunity; malignancy

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