Infection and Drug Resistance (Jul 2023)
Treatment Options for Epstein-Barr Virus-Related Disorders of the Central Nervous System
Abstract
Oluf Andersen,1 Ingemar Ernberg,2 Anna Karin Hedström3 1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Microbiology, Tumor and Cell Biology, Biomedicum Q8C, Karolinska Institutet, Stockholm, 171 77, Sweden; 3Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCorrespondence: Anna Karin Hedström, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, 171 76, Sweden, Tel +46762736426, Email [email protected]: Epstein-Barr virus (EBV), a causative agent for several types of lymphomas and mucosal cancers, is a human lymphotropic herpesvirus with the capacity to establish lifelong latent infection. More than 90% of the human population worldwide is infected. The primary infection is usually asymptomatic in childhood, whereas infectious mononucleosis (IM) is common when the infection occurs in adolescence. Primary EBV infection, with or without IM, or reactivation of latent infection in immunocompromised individuals have been associated with a wide range of neurologic conditions, such as encephalitis, meningitis, acute disseminated encephalomyelitis, and cerebellitis. EBV is also involved in malignant lymphomas in the brain. An increasing number of reports on EBV-related disorders of the central nervous system (CNS) including the convincing association with multiple sclerosis (MS) have put in focus EBV-related conditions beyond its established link to malignancies. In this review, we present the clinical manifestations of EBV-related CNS-disorders, put them in the context of known EBV biology and focus on available treatment options and future therapeutic approaches.Keywords: Epstein-Barr virus, infectious mononucleosis, central nervous system disease, multiple sclerosis, treatment, vaccination
