Epstein-Barr virus primary infection in healthy children

• Published in: Anales de Pediatría 2019-06, Vol.90 (6), p.376-385
• Main Authors: García-Peris, Mónica, Jiménez Candel, M Isabel, Mañes Jiménez, Yolanda, Pariente Martí, Macarena, González Granda, Damiana, Calvo Rigual, Fernando
• Format: Article
• Language: Spanish
• Subjects: Adolescent; Child; Child, Preschool; Epstein-Barr Virus Infections - diagnosis; Epstein-Barr Virus Infections - epidemiology; Female; Humans; Infant; Male; Retrospective Studies
• ISSN: 2341-2879
• DOI: 10.1016/j.anpedi.2018.09.003

The aim of this study is to assess epidemiological, clinical and laboratory characteristics of primary infection by Epstein-Barr virus (EBV) in children without previous diagnosis of any immune disease and its relationship with clinical presentation. A retrospective study was conducted on all children from 0 to 15 years with IgM against viral capsid of EBV positive or indeterminate during a 22 month period. Epidemiological, clinical and laboratory data were analysed and compared between typical (mononucleosis syndrome) and non-typical clinical symptoms. The study included a total of 103 children, with a median age of 7 years (3-12.5 years). Almost two-thirds (63%) of patients had typical clinical signs, with a mononucleosis syndrome, and 37% had a non-typical presentation. The non-typical clinical group had a lower age (P=.03) and took less antibiotic than the typical clinical group (P=.015). From laboratory studies, there were no differences between the groups, except in RCP, which was higher in typical clinical group (P=.04). Heterophile antibodies were positive in 33% of patients. An indeterminate IgM against viral capsid was present in 20% of the patients, and most of them had an oligosymptomatic or atypical presentation. An IgM positive for other viruses was found in 21%, and 3 of them were suspicious of false positive for EBV. In the studied population, a primary infection due to EBV is common in younger ages, and they have usually an oligosymptomatic clinical presentation. A very low percentage of positive heterophile antibodies were found. Cases with indeterminate IgM against viral capsid are more frequent in the non-typical clinical group. Co-infection with other viruses is common.