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Blood, 15 December 2001, Vol. 98, No. 13, pp. 3739-3744
IMMUNOBIOLOGY
Asymptomatic primary Epstein-Barr virus infection occurs in the
absence of blood T-cell repertoire perturbations despite high levels of
systemic viral load
Sharon L. Silins,
Martina
A. Sherritt,
Jodie M. Silleri,
Simone M. Cross,
Suzanne L. Elliott,
Mandvi Bharadwaj,
Thuy T. T. Le,
Leanne E. Morrison,
Rajiv Khanna,
Denis J. Moss,
Andreas Suhrbier, and
Ihor S. Misko
From the Infectious Disease and Immunology Division,
Queensland Institute of Medical Research and Joint Oncology Program,
University of Queensland, Herston, Australia.
Primary infection with the human herpesvirus, Epstein-Barr virus
(EBV), may result in subclinical seroconversion or may appear as
infectious mononucleosis (IM), a lymphoproliferative disease of
variable severity. Why primary infection manifests differently between
patients is unknown, and, given the difficulties in identifying donors
undergoing silent seroconversion, little information has been
reported. However, a longstanding assumption has been held that
IM represents an exaggerated form of the virologic and immunologic events of asymptomatic infection. T-cell receptor (TCR)
repertoires of a unique cohort of subclinically infected patients
undergoing silent infection were studied, and the results highlight a
fundamental difference between the 2 forms of infection. In contrast to
the massive T-cell expansions mobilized during the acute symptomatic phase of IM, asymptomatic donors largely maintain homeostatic T-cell
control and peripheral blood repertoire diversity. This disparity
cannot simply be linked to severity or spread of the infection because
high levels of EBV DNA were found in the blood from both types of acute
infection. The results suggest that large expansions of T cells within
the blood during IM may not always be associated with the control of
primary EBV infection and that they may represent an overreaction that
exacerbates disease.
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