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Virology of Epstein-Barr virus

John L Sullivan, MD
Katherine Luzuriaga, MD
Section Editors
Martin S Hirsch, MD
Morven S Edwards, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Epstein-Barr virus (EBV) is a widely disseminated herpesvirus (human herpes virus 4), which is spread by intimate contact between susceptible persons and asymptomatic EBV shedders. The majority of primary EBV infections throughout the world are subclinical and unapparent. Antibodies to EBV have been demonstrated in all population groups with a worldwide distribution; approximately 90 to 95 percent of adults are EBV-seropositive.

Like other members of the herpesvirus family, EBV has a latency phase. The host cells for the organism in humans are B lymphocytes, T lymphocytes, epithelial cells and myocytes. Unlike herpes simplex (HSV) or cytomegalovirus (CMV), EBV is capable of transforming B cells and does not routinely display a cytopathic effect in cell culture.

EBV is the primary agent of infectious mononucleosis, persists asymptomatically for life in most adults, and is associated with the development of B cell lymphomas, T cell lymphomas, Hodgkin lymphoma and nasopharyngeal carcinomas in certain patients. Reactivation disease is not a prominent issue with EBV, in contrast to other prominent herpesviruses, but it has been associated with an aggressive lymphoproliferative disorder in transplant recipients. (See "Treatment and prevention of post-transplant lymphoproliferative disorders".)

The virology and biology of EBV will be reviewed here. The epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of EBV infections are discussed separately. (See "Clinical manifestations and treatment of Epstein-Barr virus infection".)


EBV is a member of the gamma herpesvirus family and is the prototype for the lymphocryptovirus genus. In vitro, all gamma herpesviruses replicate in lymphoid cells and some are capable of lytic replication in epithelial cells and fibroblasts. Infection of primate B lymphocytes typically results in latent infection. This is characterized by persistence of the viral genome along with expression of a restricted set of latent gene products, which contribute to the transformation process and help drive cell proliferation [1].

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