Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 199, Issue 1, Pages 31-38Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/594373
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Funding
- UK Medical Research Council (MRC), London
- Cancer Research UK
- MRC Clinical Training Fellowship
- MRC New Investigator Award.
- Medical Research Council [G9901249, G0501074, G9818340B] Funding Source: researchfish
- MRC [G0501074, G9901249] Funding Source: UKRI
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Background. To investigate how intense Plasmodium falciparum infection predisposes to Epstein-Barr virus (EBV)-positive Burkitt lymphoma (BL), we analyzed the effect of acute malaria on existing EBV-host balance. Methods. EBV genome loads in peripheral blood mononuclear cells were assayed by quantitative polymerase chain reaction, and EBV-specific CD8(+) T cell responses were assayed by interferon-gamma enzyme-linked immunospot assay. Results. Gambian children, from whom samples were obtained during an acute malaria attack and again up to 6 weeks later, had extremely high viral loads, reaching levels that in the United Kingdom are seen only in patients with infectious mononucleosis. Gambian control subjects ( children and adults with no recent history of malaria) had lower median viral loads, although they were still > 10-fold above the median for healthy UK adults. Limited experiments with EBV epitope peptides (restricted through the HLA-B*3501 and HLA-B*5301 alleles) also suggested an impairment of virus-specific CD8(+) T cell function in children with malaria, but only during acute disease. Conclusions. Acute malaria is associated with sustained increase in EBV load and, possibly, a transient decrease in EBV-specific T cell surveillance. We infer that the unusually high set point of virus carriage in P. falciparum challenged populations, allied with the parasite's capacity to act as a chronic B cell stimulus, probably contributes to the pathogenesis of endemic BL.
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