Objectives: To: (i) evaluate longitudinally the prevalence of Epstein-Barr virus (EBV) DNA in the cervix of healthy teenage girls, (ii) relate the presence of cervical EBV DNA to virginity or sexual experience, and (iii) relate the occurrence of cervical EBV DNA to the presence of specific IgG antibodies to EBV virus capsid antigen (EBV-VCA) in serum and to signs of genital infection.
Material and methods: Thirty-six teenage girls were followed for 2 years between the ages of 16 and 18 years. A sexual history was taken and a gynecological examination was performed on each occasion. The presence of EBV DNA in the cervix and of EBV VCA antibodies in serum was determined on each occasion.
Results: Coitus debut was reported by 23/36 girls (64%) and by 31/36 (86%) at 16- and 18-years of age, respectively. Two girls (only one with sexual debut) harbored EBV DNA in the cervix at 16 years of age. At the age of 18, no EBV DNA was found in these two girls, but another three girls carried EBV DNA in the cervix. All were sexually active and reported 1, 4 and 7 life-time sexual partners respectively. Serum EBV-VCA antibodies were found in 83% of the 16-year old girls and in 89% of the 18-year old girls (no significant difference between sexually experienced and virginal girls at either age). All the girls with cervical EBV DNA had antibodies against EBV-VCA. None of the girls with EBV DNA were found to carry HPV DNA or have a chlamydial infection in the cervix at any time during the study. There was no significant difference in the number of girls with a cervix secretion predominated by leucocytes between girls with positive and negative cervical EBV DNA samples.
Conclusions: We conclude that among these healthy teenage girls the non-sexual route of transmission of EBV is more plausible than the sexual one.