A Cohort Study among University Students: Identification of Risk Factors for Epstein‐Barr Virus Seroconversion and Infectious Mononucleosis
Open Access
- 1 August 2006
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 43 (3), 276-282
- https://doi.org/10.1086/505400
Abstract
Background. A vaccine against Epstein-Barr virus (EBV) infection is in clinical trials. Up-to-date information on risk factors for EBV infection and infectious mononucleosis (IM) among young adults is required to inform a vaccination strategy. Methods. We carried out a prospective study on a cohort of university students. All EBV-seronegative students were asked to report symptoms of IM and were followed up 3 years later to undergo repeat EBV testing and to complete a lifestyle questionnaire. EBV typing was performed for these subjects, as well as for students who were EBV seropositive at enrollment and for additional students with IM. Results. A total of 510 students (25%) who took part in the study were EBV seronegative when they entered the university; 110 (46%) of these experienced seroconversion while at the university, 27 (25%) of whom developed IM. Penetrative sexual intercourse was a risk factor for EBV seroconversion (P = .004), but neither condom use nor oral sex significantly altered the rate of seroconversion. EBV type 1 was significantly overrepresented in IM, compared with silent seroconversion (P = .001). Conclusions. Our findings suggest that acquisition of EBV is enhanced by penetrative sexual intercourse, although transmission could occur through related sexual behaviors, such as “deep kissing.” We also found that EBV type 1 infection is significantly more likely to result in IM. Overall, the results suggest that a large EBV type 1 load acquired during sexual intercourse can rapidly colonize the B cell population and induce the exaggerated T cell response that causes IM. Thus, IM could, perhaps, be prevented with a vaccine that reduces the viral load without necessarily inducing sterile immunity.Keywords
This publication has 25 references indexed in Scilit:
- Sexual History and Epstein‐Barr Virus InfectionThe Journal of Infectious Diseases, 2002
- Immunology of the tonsilsImmunology Today, 1998
- Serum Cytokine Profiles in Acute Primary HIV-1 Infection and in Infectious MononucleosisClinical Immunology and Immunopathology, 1996
- Odds Ratios in Cross-Sectional StudiesInternational Journal of Epidemiology, 1995
- Subclinical Epstein-Barr Virus Infection of both the Male and Female Genital Tract–Indication for Sexual TransmissionJournal of Investigative Dermatology, 1992
- A re‐examination of the epstein‐barr virus carrier state in healthy seropositive individualsInternational Journal of Cancer, 1985
- Epidemiological evidence for causal relationship between Epstein-Barr virus and Burkitt's lymphoma from Ugandan prospective studyNature, 1978
- Cellular localization of an Epstein‐Barr virus (EBV)‐associated complement‐fixing antigen in producer and non‐producer lymphoblastoid cell linesInternational Journal of Cancer, 1973
- Infectious Mononucleosis and its Relationship to EB Virus Antibody: A JOINT INVESTIGATION BY UNIVERSITY HEALTH PHYSICIANS AND P.H.L.S. LABORATORIESBMJ, 1971
- Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodiesPublished by American Medical Association (AMA) ,1968