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October 1985, Vol 139, No. 10 >
Article | October 1985

Epstein-Barr Virus Infection in a Child With Acquired Immunodeficiency Syndrome FREE

James C. Fackler, MD; James E. Nagel, MD; William H. Adler, MD; Patricia T. Mildvan, MD; Richard F. Ambinder, MD
[+] Author Affiliations

Reprint requests to Clinical Immunology Section, Gerontology Research Center, 4940 Eastern Ave, Baltimore, MD 21224 (Dr Nagel).


Am J Dis Child. 1985;139(10):1000-1004. doi:10.1001/archpedi.1985.02140120046026.
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• A 3-year-old girl, born to an intravenous-drug-dependent mother, had protracted diarrhea, failure to thrive, generalized lymphadenopathy, and recurrent fevers during the first six months of life. At 7 months of age, the Epstein-Barr virus (EBV) genome was detected in her saliva by DNA dot-blot hybridization using a cloned EBV probe. Spontaneous EBV+ lymphoblastoid cell lines had repeatedly developed from her peripheral blood lymphocytes over the subsequent 2½ years. At 11 months of age, persistent tachypnea and a diffuse pulmonary infiltrate developed. Lung biopsy demonstrated a florid, peribronchiolar lymphocytic infiltrate and the EBV genome was identified in the lung tissue. Serum anti-EBV antibodies remained undetectable until 14 months of age. She had a T4+/T8+ ratio of less than 0.8 and serum antibody to human T-cell lymphotropic virus type III. The delayed seroresponse of this patient to symptomatic EBV infection suggests that reliance on EBV serology to diagnose EBV infection in immunocompromised hosts may be inappropriate, and other methods such as DNA probes should be used.

(AJDC 1985;139:1000-1004)

REFERENCES

1 +
Rubinstein A, Sicklick M, Gupta A, et al:  Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers . JAMA 1983;;249:2350-2356.
2 +
Oleske J, Minnefor A, Cooper R, et al:  Immune deficiency syndrome in children . JAMA 1983;;249:2345-2349.
3 +
Joncas JH, Delage G, Chad Z, et al:  Acquired (or congenital) immunodeficiency syndrome in infants born of Haitian mothers . N Engl J Med 1983;;308:842.
4 +
Shannon K, Ball E, Wasserman RL, et al:  Transfusion-associated cytomegalovirus infection and acquired immune deficiency syndrome in an infant . J Pediatr 1983;;103:859-863.
5 +
Scott GB, Buck BE, Leterman JG, et al:  Acquired immunodeficiency syndrome in infants . N Engl J Med 1984;;310:76-81.
6 +
O'Duffy JF, Isles AF:  Transfusion-induced AIDS in four premature babies . Lancet 1984;;2: 1346.
7 +
Buck BE, Scott GB, Valdes-Dapena M, et al:  Kaposi sarcoma in two infants with acquired immune deficiency syndrome . J Pediatr 1983;;103: 911-913.
8 +
Ammann AJ, Kaminsky L, Cowan M, et al:  Antibodies to AIDS-associated retrovirus distinguish between pediatric primary and acquired immunodeficiency syndrome . JAMA 1985;;253: 3116-3118.
9 +
Silverman B, Charytan M, Krieger B, et al:  Chronic interstitial pneumonitis in pediatric AIDS and AIDS-related complex (prodrome), abstracted . Pediatr Res 1984;;18:265.
10 +
Schmidt W, McIntosh LS, Miller G, et al:  Reversal of signs and symptoms of acquired immunodeficiency syndrome (AIDS) with prednisone, abstracted . Pediatr Res 1984;;18:264.
11 +
Charytan M, Krieger BZ, Wiznia A, et al:  Treatment of AIDS-associated lymphoid interstitial pneumonitis with intravenous gamma-globulin and prednisone , abstracted. Pediatr Res 1985;;19:401.
12 +
Uchiyama T, Broder S, Waldmann TA:  A monoclonal antibody (anti-Tac) reactive with activated and functionally mature human T cells: I. Production of anti-Tac monoclonal antibody and distribution of Tac (+) cells . J Immunol 1981;; 126:1393-1397.
13 +
Maniatis T, Fritsch EF, Sambrook J: Molecular Cloning . Cold Spring Harbor, NY, Cold Spring Harbor Laboratory, 1982;, pp 280-281.
14 +
Ambinder RF, Wingard JR, Burnes WH, et al:  Detection of Epstein-Barr virus DNA in mouthwashes by hybridization . J Clin Microbiol 1985;;21:353-356.
15 +
Hayward SD, Lazarowitz SG, Hayward GS:  Organization of the Epstein-Barr virus DNA molecule: II. Fine mapping of the boundaries of the internal repeat cluster of B95-8 and identification of additional small tandem repeats adjacent to the HR-1 deletion . J Virol 1982;;43:201-212.
16 +
Bender BS, Curtis JL, Nagel JE, et al:  Analysis of immune status of hemodialyzed adults: Association with prior transfusions . Kidney Int 1984;;26:436-443.
17 +
Sullivan JL, Byron KS, Brewmaster FE, et al:  Treatment of life-threatening Epstein-Barr virus infections with acyclovir . Am J Med 1982;; 73:262-266.
18 +
Cooper DA, Maclean P, Finlayson R, et al:  Acute AIDS retrovirus infection: Definition of a clinical illness associated with seroconversion . Lancet 1985;;1:537-540.
19 +
Straus SE, Tosato G, Armstrong G, et al:  Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection . Ann Intern Med 1985;;102:7-16.
20 +
Jones JF, Ray CG, Minnich LL, et al:  Evidence for active Epstein-Barr virus infection in patients with persistent, unexplained illnesses: Elevated anti-early antigen antibodies . Ann Intern Med 1985;;102:1-7.
21 +
Saemunden AK, Purtilo DT, Sakamoto K, et al:  Documentation of Epstein-Barr virus infection in immunodeficient patients with life-threatening lymphoproliferative disease by Epstein-Barr virus complementary RNA/DNA and viral DNA/DNA hybridization . Cancer Res 1981;;41: 4237-4242.
22 +
Rickinson AB, Moss DJ, Wallace LE, et al:  Long-term T-cell–mediated immunity to Epstein-Barr virus . Cancer Res 1981;;41:4216-4221.
23 +
Horowitz CA, Henle W, Henle G, et al:  Long-term serological follow-up of patients for Epstein-Barr virus after recovery from infectious mononucleosis . J Infect Dis 1985;;151:1150-1151.
24 +
Lung ML, So SY, Chan KH, et al:  Evidence that respiratory tract is major reservoir for Epstein-Barr virus . Lancet 1985;;1:889-892.
25 +
Hellman N, Cowan MJ, Ammann AJ, et al:  Chronic active Epstein-Barr virus infections in two immunodeficient patients . J Pediatr 1983;; 103:585-588.
26 +
Miller G, Grogan E, Fischer DK, et al:  Antibody responses to two Epstein-Barr virus nuclear antigens defined by gene transfer . N Engl J Med 1985;;312:750-755.
27 +
Lane HC, Masur H, Edgar LC, et al:  Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome . N Engl J Med 1983;; 309:453-458.
28 +
Rubinstein A, Sicklick M, Bernstein L, et al:  Treatment of AIDS with intravenous gammaglobulin , abstracted. Pediatr Res 1984;;18:264.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Rubinstein A, Sicklick M, Gupta A, et al:  Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers . JAMA 1983;;249:2350-2356.
2 +
Oleske J, Minnefor A, Cooper R, et al:  Immune deficiency syndrome in children . JAMA 1983;;249:2345-2349.
3 +
Joncas JH, Delage G, Chad Z, et al:  Acquired (or congenital) immunodeficiency syndrome in infants born of Haitian mothers . N Engl J Med 1983;;308:842.
4 +
Shannon K, Ball E, Wasserman RL, et al:  Transfusion-associated cytomegalovirus infection and acquired immune deficiency syndrome in an infant . J Pediatr 1983;;103:859-863.
5 +
Scott GB, Buck BE, Leterman JG, et al:  Acquired immunodeficiency syndrome in infants . N Engl J Med 1984;;310:76-81.
6 +
O'Duffy JF, Isles AF:  Transfusion-induced AIDS in four premature babies . Lancet 1984;;2: 1346.
7 +
Buck BE, Scott GB, Valdes-Dapena M, et al:  Kaposi sarcoma in two infants with acquired immune deficiency syndrome . J Pediatr 1983;;103: 911-913.
8 +
Ammann AJ, Kaminsky L, Cowan M, et al:  Antibodies to AIDS-associated retrovirus distinguish between pediatric primary and acquired immunodeficiency syndrome . JAMA 1985;;253: 3116-3118.
9 +
Silverman B, Charytan M, Krieger B, et al:  Chronic interstitial pneumonitis in pediatric AIDS and AIDS-related complex (prodrome), abstracted . Pediatr Res 1984;;18:265.
10 +
Schmidt W, McIntosh LS, Miller G, et al:  Reversal of signs and symptoms of acquired immunodeficiency syndrome (AIDS) with prednisone, abstracted . Pediatr Res 1984;;18:264.
11 +
Charytan M, Krieger BZ, Wiznia A, et al:  Treatment of AIDS-associated lymphoid interstitial pneumonitis with intravenous gamma-globulin and prednisone , abstracted. Pediatr Res 1985;;19:401.
12 +
Uchiyama T, Broder S, Waldmann TA:  A monoclonal antibody (anti-Tac) reactive with activated and functionally mature human T cells: I. Production of anti-Tac monoclonal antibody and distribution of Tac (+) cells . J Immunol 1981;; 126:1393-1397.
13 +
Maniatis T, Fritsch EF, Sambrook J: Molecular Cloning . Cold Spring Harbor, NY, Cold Spring Harbor Laboratory, 1982;, pp 280-281.
14 +
Ambinder RF, Wingard JR, Burnes WH, et al:  Detection of Epstein-Barr virus DNA in mouthwashes by hybridization . J Clin Microbiol 1985;;21:353-356.
15 +
Hayward SD, Lazarowitz SG, Hayward GS:  Organization of the Epstein-Barr virus DNA molecule: II. Fine mapping of the boundaries of the internal repeat cluster of B95-8 and identification of additional small tandem repeats adjacent to the HR-1 deletion . J Virol 1982;;43:201-212.
16 +
Bender BS, Curtis JL, Nagel JE, et al:  Analysis of immune status of hemodialyzed adults: Association with prior transfusions . Kidney Int 1984;;26:436-443.
17 +
Sullivan JL, Byron KS, Brewmaster FE, et al:  Treatment of life-threatening Epstein-Barr virus infections with acyclovir . Am J Med 1982;; 73:262-266.
18 +
Cooper DA, Maclean P, Finlayson R, et al:  Acute AIDS retrovirus infection: Definition of a clinical illness associated with seroconversion . Lancet 1985;;1:537-540.
19 +
Straus SE, Tosato G, Armstrong G, et al:  Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection . Ann Intern Med 1985;;102:7-16.
20 +
Jones JF, Ray CG, Minnich LL, et al:  Evidence for active Epstein-Barr virus infection in patients with persistent, unexplained illnesses: Elevated anti-early antigen antibodies . Ann Intern Med 1985;;102:1-7.
21 +
Saemunden AK, Purtilo DT, Sakamoto K, et al:  Documentation of Epstein-Barr virus infection in immunodeficient patients with life-threatening lymphoproliferative disease by Epstein-Barr virus complementary RNA/DNA and viral DNA/DNA hybridization . Cancer Res 1981;;41: 4237-4242.
22 +
Rickinson AB, Moss DJ, Wallace LE, et al:  Long-term T-cell–mediated immunity to Epstein-Barr virus . Cancer Res 1981;;41:4216-4221.
23 +
Horowitz CA, Henle W, Henle G, et al:  Long-term serological follow-up of patients for Epstein-Barr virus after recovery from infectious mononucleosis . J Infect Dis 1985;;151:1150-1151.
24 +
Lung ML, So SY, Chan KH, et al:  Evidence that respiratory tract is major reservoir for Epstein-Barr virus . Lancet 1985;;1:889-892.
25 +
Hellman N, Cowan MJ, Ammann AJ, et al:  Chronic active Epstein-Barr virus infections in two immunodeficient patients . J Pediatr 1983;; 103:585-588.
26 +
Miller G, Grogan E, Fischer DK, et al:  Antibody responses to two Epstein-Barr virus nuclear antigens defined by gene transfer . N Engl J Med 1985;;312:750-755.
27 +
Lane HC, Masur H, Edgar LC, et al:  Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome . N Engl J Med 1983;; 309:453-458.
28 +
Rubinstein A, Sicklick M, Bernstein L, et al:  Treatment of AIDS with intravenous gammaglobulin , abstracted. Pediatr Res 1984;;18:264.

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