Epstein-Barr Virus Infection and Disease

Primary Infection and Target Cells

• EBV primarily infects and transforms B lymphocytes, though it can also infect T cells and NK cells under certain pathological conditions, particularly in chronic active EBV infection and specific lymphoproliferative disorders 1, 2, 3
• The virus uses CD21 (complement receptor 2) on B cells as its primary entry receptor, making B lymphocytes the natural target 4

B Cell-Mediated Disease Manifestations

• Post-transplant lymphoproliferative disorders (PTLD) arise predominantly from EBV-infected B lymphocytes in immunosuppressed patients 5
• The oncogenic potential of EBV relates specifically to its ability to transform and immortalize B lymphocytes, leading to uncontrolled proliferation 5
• EBV-associated B-cell lymphomas express different latency patterns (latency I, II, or III) depending on the specific disease entity 1, 6

T Cell and NK Cell Involvement

• In chronic active EBV infection (CAEBV), the virus distinctly targets cells other than B lymphocytes, including T cells and NK cells 1, 2, 3
• Patients with CAEBV often develop T-cell or NK-cell lymphoproliferative disorders and malignant lymphomas during disease progression 8, 6, 4

Immune Response Context

• EBV-specific cytotoxic T lymphocytes (CTLs) are the most important immune mechanism for controlling EBV-infected B cell proliferation 8, 6
• CD8+ CTLs target viral proteins EBNA-2, EBNA-3 family, and LMP-1 expressed on infected B cells 1, 6