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Frequency of Epstein - Barr Virus in Patients Presenting with Acute Febrile Illness in Kenya.

Masakhwe C, Ochanda H, Nyakoe N, Ochiel D, Waitumbi J - PLoS ONE (2016)

Bottom Line: EBV was detected in blood using quantitative TaqMan-based qPCR targeting a highly conserved BALF5 gene.Furthermore, patients from the malaria endemic coastal region and the Lake Victoria region presented with significantly higher viremia than individuals from other regions of Kenya.This study provides profiles of EBV in patients with AFI from diverse eco-regions of Kenya.

View Article: PubMed Central - PubMed

Affiliation: School of Biological Sciences, University of Nairobi, Nairobi, Kenya.

ABSTRACT

Background: Most acute febrile illnesses (AFI) are usually not associated with a specific diagnosis because of limitations of available diagnostics. This study reports on the frequency of EBV viremia and viral load in children and adults presenting with febrile illness in hospitals in Kenya.

Methodology/principal findings: A pathogen surveillance study was conducted on patients presenting with AFI (N = 796) at outpatient departments in 8 hospitals located in diverse regions of Kenya. Enrollment criterion to the study was fever without a readily diagnosable infection. All the patients had AFI not attributable to the common causes of fever in Kenyan hospitals, such as malaria or rickettsiae, leptospira, brucella and salmonella and they were hence categorized as having AFI of unknown etiology. EBV was detected in blood using quantitative TaqMan-based qPCR targeting a highly conserved BALF5 gene. The overall frequency of EBV viremia in this population was 29.2%, with significantly higher proportion in younger children of <5years (33.8%, p = 0.039) compared to patients aged ≥5 years (26.3% for 5-15 years or 18.8% for >15 years). With respect to geographical localities, the frequency of EBV viremia was higher in the Lake Victoria region (36.4%), compared to Kisii highland (24.6%), Coastal region (22.2%) and Semi-Arid region (25%). Furthermore, patients from the malaria endemic coastal region and the Lake Victoria region presented with significantly higher viremia than individuals from other regions of Kenya.

Conclusions/significance: This study provides profiles of EBV in patients with AFI from diverse eco-regions of Kenya. Of significant interest is the high frequency of EBV viremia in younger children. The observed high frequencies of EBV viremia and elevated viral loads in residents of high malaria transmission areas are probably related to malaria induced immune activation and resultant expansion of EBV infected B-cells.

No MeSH data available.


Related in: MedlinePlus

Frequency of EBV viremia among different age categories.Frequency of EBV was highest among children under 5 years, and was significantly different between <5 years vs. 5–15 years (p = 0.039) and between <5 years and >15 years (p = 0.002) age categories.
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pone.0155308.g002: Frequency of EBV viremia among different age categories.Frequency of EBV was highest among children under 5 years, and was significantly different between <5 years vs. 5–15 years (p = 0.039) and between <5 years and >15 years (p = 0.002) age categories.

Mentions: As shown in Fig 2, the risk of having EBV decreases with age. The highest proportion was observed in children under 5 years (33.8%) compared to 26.3% (p = 0.039) in 5–15 years and 18.8% in those older than 15 years (p = 0.002). The viral load ranged from 392.5 to 8.68 x105 copies/mL (geometric mean of 5,859 copies/mL, 95% CI 4,916–6,982). Comparable viral loads were observed in patients under 5 years (geometric mean, 6,970 copies/mL, 95% CI 5,609–8,661, p = 0.875, t-test) and those over 15 years (geometric mean of 7,317 copies/mL, 95% CI 3,639–14,7145) and was lowest in patients 5–15 years (geometric mean, 3,795 copies/mL, 95% CI 2,774–5,191) (Fig 3). Viral load ≥5000 copies/mL were observed in 59% of the individuals in the age bracket <5 years (84/142) and those ≥15 years (13/22) and only 35% (24/68) in individuals between 5–15 years. 5000 copies/mL was suggested to be the average value associated with symptomatic EBV infections in immunocompetent patients [14,25].


Frequency of Epstein - Barr Virus in Patients Presenting with Acute Febrile Illness in Kenya.

Masakhwe C, Ochanda H, Nyakoe N, Ochiel D, Waitumbi J - PLoS ONE (2016)

Frequency of EBV viremia among different age categories.Frequency of EBV was highest among children under 5 years, and was significantly different between <5 years vs. 5–15 years (p = 0.039) and between <5 years and >15 years (p = 0.002) age categories.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4862666&req=5

pone.0155308.g002: Frequency of EBV viremia among different age categories.Frequency of EBV was highest among children under 5 years, and was significantly different between <5 years vs. 5–15 years (p = 0.039) and between <5 years and >15 years (p = 0.002) age categories.
Mentions: As shown in Fig 2, the risk of having EBV decreases with age. The highest proportion was observed in children under 5 years (33.8%) compared to 26.3% (p = 0.039) in 5–15 years and 18.8% in those older than 15 years (p = 0.002). The viral load ranged from 392.5 to 8.68 x105 copies/mL (geometric mean of 5,859 copies/mL, 95% CI 4,916–6,982). Comparable viral loads were observed in patients under 5 years (geometric mean, 6,970 copies/mL, 95% CI 5,609–8,661, p = 0.875, t-test) and those over 15 years (geometric mean of 7,317 copies/mL, 95% CI 3,639–14,7145) and was lowest in patients 5–15 years (geometric mean, 3,795 copies/mL, 95% CI 2,774–5,191) (Fig 3). Viral load ≥5000 copies/mL were observed in 59% of the individuals in the age bracket <5 years (84/142) and those ≥15 years (13/22) and only 35% (24/68) in individuals between 5–15 years. 5000 copies/mL was suggested to be the average value associated with symptomatic EBV infections in immunocompetent patients [14,25].

Bottom Line: EBV was detected in blood using quantitative TaqMan-based qPCR targeting a highly conserved BALF5 gene.Furthermore, patients from the malaria endemic coastal region and the Lake Victoria region presented with significantly higher viremia than individuals from other regions of Kenya.This study provides profiles of EBV in patients with AFI from diverse eco-regions of Kenya.

View Article: PubMed Central - PubMed

Affiliation: School of Biological Sciences, University of Nairobi, Nairobi, Kenya.

ABSTRACT

Background: Most acute febrile illnesses (AFI) are usually not associated with a specific diagnosis because of limitations of available diagnostics. This study reports on the frequency of EBV viremia and viral load in children and adults presenting with febrile illness in hospitals in Kenya.

Methodology/principal findings: A pathogen surveillance study was conducted on patients presenting with AFI (N = 796) at outpatient departments in 8 hospitals located in diverse regions of Kenya. Enrollment criterion to the study was fever without a readily diagnosable infection. All the patients had AFI not attributable to the common causes of fever in Kenyan hospitals, such as malaria or rickettsiae, leptospira, brucella and salmonella and they were hence categorized as having AFI of unknown etiology. EBV was detected in blood using quantitative TaqMan-based qPCR targeting a highly conserved BALF5 gene. The overall frequency of EBV viremia in this population was 29.2%, with significantly higher proportion in younger children of <5years (33.8%, p = 0.039) compared to patients aged ≥5 years (26.3% for 5-15 years or 18.8% for >15 years). With respect to geographical localities, the frequency of EBV viremia was higher in the Lake Victoria region (36.4%), compared to Kisii highland (24.6%), Coastal region (22.2%) and Semi-Arid region (25%). Furthermore, patients from the malaria endemic coastal region and the Lake Victoria region presented with significantly higher viremia than individuals from other regions of Kenya.

Conclusions/significance: This study provides profiles of EBV in patients with AFI from diverse eco-regions of Kenya. Of significant interest is the high frequency of EBV viremia in younger children. The observed high frequencies of EBV viremia and elevated viral loads in residents of high malaria transmission areas are probably related to malaria induced immune activation and resultant expansion of EBV infected B-cells.

No MeSH data available.


Related in: MedlinePlus