Clinical Characteristics of Peripheral Lymphocyte Subtypes in Chronic Active Epstein-Barr Virus Infection

• Published in: The Journal of infectious diseases Vol. 230; no. 1; p. 95
• Main Authors: Wei, Ang, Ou, Wenxin, Zhao, Yunze, Ma, Honghao, Zhang, Liping, Lian, Hongyun, Zhao, Xiaoxi, Zhang, Qing, Wang, Dong, Li, Zhigang, Wang, Tianyou, Zhang, Rui
• Format: Journal Article
• Language: English
• Published: United States 25.07.2024
• Subjects: Adolescent; CD4-Positive T-Lymphocytes - immunology; CD56 Antigen; CD8-Positive T-Lymphocytes - immunology; Child; Child, Preschool; Chronic Disease; DNA, Viral - blood; Epstein-Barr Virus Infections - immunology; Epstein-Barr Virus Infections - virology; Female; Hematopoietic Stem Cell Transplantation; Herpesvirus 4, Human - immunology; Humans; Infant; Killer Cells, Natural - immunology; Lymphocyte Subsets - immunology; Male; Prognosis; infected lymphocyte subtype; clinical characteristic; prognosis; chronic active Epstein-Barr virus infection
• ISSN: 1537-6613

We aimed to analyze the clinical characteristics of peripheral Epstein-Barr virus (EBV)-infected lymphocyte subtypes in children with chronic active EBV infection (CAEBV). The levels of peripheral EBV infection of CD4+ T cells, CD8+ T cells, and CD56+ natural killer (NK) cells were determined by flow cytometry and quantitative polymerase chain reaction (qPCR) in patients with CAEBV from July 2017 to July 2022. In total, 112 children with CAEBV were evaluated. Of these, CD4+ type, CD8+ type, and CD56+ type were defined in 44, 21, and 47 patients, respectively. Patients with CD8+ T-cell type had a significantly higher frequency of rash, while hepatomegaly was more common in patients with CD4+ T-cell type. Generally, patients with CD8+ T-cell type had the lowest overall survival rate (P = .017). Patients treated with chemotherapy and hematopoietic stem cell transplantation (HSCT) had a better prognosis (P = .001). In multivariate analysis, rash, hemophagocytic lymphohistiocytosis, CD8+ T-cell type, and no decrease of plasma EBV-DNA after treatment were independent indicators of poor prognosis (P = .002, .024, .022, and .012, respectively). In children with CAEBV, rash was more frequent in patients with CD8+ T-cell type, whereas patients with CD4+ T-cell type were more likely to develop hepatomegaly. Patients with CD8+ T-cell type had a poor prognosis despite receiving chemotherapy or further HSCT.