Hodgkin’s Lymphoma associated Epstein-Barr Virus (EBV) infectionSIDDHESH U. SAPREROLL NUMBER- 17M.SC. VIROLOGY – PART INATIONAL INSTITUTE OF VIROLOGY (NIV), PUNE
Epstein Barr Virus/
HHV-4
Tegument Family: Herpesviridae
Subfamily: Gammaherpesviri
naeGenus:
Lymphocryptovirus
Nucleic acid: Linear, double stranded DNA
(184 kbp)
Enveloped, Spherical or pleomorphic
Icosahedral symmetry
Modes of transmission:1. Exposure to infected body secretions
2. Respiratory tract and mucous membranes
3. Parenteral exposure (transfusion) rare
Structure and infectious cycle(EBV):
viral envelope glycoprotein gp350/220
cellular receptor for the C3d complement component CR2 (CD 21)
gp25, gp42 & gp85
B-lymphocyte (APC)
EBV is an etiological agent for:
1. Infectious mononucleosis 2. Hodgkin’s lymphoma (after
Dr.Thomas Hodgkin) 3. Burkitt’s lymphoma 4. AIDS-related lymphoma 5. Post-transplant
lymphoproliferative disease (PTLD) 6. Nasopharyngeal carcinoma Let’s explore Hodgkin’s lymphoma
now……………………!
Hodgkin’s lymphoma
Lymphoid tissue is present throughout the body HD can start practically anywhere inside the body (most often starts in the lymph nodes in the upper part of the body)
Sites: in the neck, in the chest or under the arm Most often spreads through the lymph nodes in a
stepwise fashion from lymph node to lymph node In the late stage (rare), it invades the blood stream and
spreads throughout the body (liver, lungs, and bone marrow)
Types of Hodgkin’s disease (appearance under microscope) Classical HD (95% case in the world) Reed-Sternberg cells (abnormal type
of B lymphocyte, much larger than normal lymphocytes,)
Classical HD has 4 subtypes
Mixed cellularity
HD Lymphocyte
rich HD Nodular sclerosis
HD
Lymphocyte depleted
HD
People who have had infectious mononucleosis (mono),an infection caused by the Epstein-Barr virus (EBV), have an increased risk of Hodgkin disease.
Signs and symptoms of HD:
Lumps under the skin Cough, trouble breathing, chest pain General (non-specific) symptoms/ B
symptoms: Fever without an infection Drenching night sweats Weight loss of the body (unintentional,
more than 10% of the body weight in about 6 months)
Treatment of HD:
Radiation therapy (involved site/ involved field ) PBSCT, BMT Chemotherapy for HD:o Adriamycin (doxorubicin)o Bleomycino Vinblastineo Dacarbazine (DITC)o Generally ABVD and BEACOPP regimens are usedo mAb therapy (Brentuximab vedotin, Rituximab)
Factors that show the presence of EBV infection in B lymphocytes
fluorescent situ hybridisation technique to detect EBV DNA (EBER1 & EBER 2) sequences (latent infection in situ) ( GOLD Std. for Clinical
samples) Also express high levels of (EBNA), (LMP) LMP (CD23 & CD40) IL-10 production , upregulation of ICAM, Lymphocyte Function associated
Antigen (LFA), downregulation of CD99 Protects B cells from cell death by upregulation of several anti-apoptotic
genes including bcl-2, mcl-1 and A-20
Treatment of Epstein Barr Virus infections
no vaccine protected by close physical contact, food, or personal items,
like toothbrushes, with people who have EBV infection
To summarise:
Epstein Barr virus is associated with about 37% of the cases of all lymphomas- including the Hodgkin’s disease
Early EBV infection associated with immunocompromised status or transplantation/ transfusions can increase the risk of EBV infections causing lymphoma
In about 90% of the cases which are infected with EBV, it remains latent throughout the life cycle of the subject and doesn’t lead to malignancies
Hodgkin’s lymphoma is curable even in the late state of malignancy
THANKS!!!
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