摘要
EB病毒(Epstein-Barr virus,EBV)是一种全球各人种普遍感染且终生携带的一类γ疱疹病毒.一般情况不引发疾病,但越来越多证据表明,其感染与多种严重疾病密切相关.了解EBV感染的流行病学特征对于预防和治疗EBV相关疾病至关重要.本文对EBV的自然感染史及其特征进行综述,包括感染途径、潜伏状态和裂解复制过程;进一步分析影响EBV感染的环境和遗传因素;此外,本文还对EBV相关疾病的流行病学特征进行概述,包括传染性单核细胞增多症、多发性硬化症、系统性红斑狼疮,以及恶性肿瘤如淋巴瘤、鼻咽癌、胃癌等,特别强调HLA等免疫相关遗传基因在病毒致癌中的关键作用.基于EBV血清学、游离核酸及甲基化等新型标志物,探讨这些标志物在疾病诊断中的重要作用.本文旨在为深入理解EBV相关疾病的病因、发病机制和预防措施提供详实的流行病学依据.
Abstract
Epstein-Barr virus(EBV),a member of the γ-herpes virus family,is commonly found in almost all humans worldwide and establishes a lifelong infection.Although most individuals remain asymptomatic after infection,mounting evidence suggests a significant association between EBV and various serious diseases.This review provides a comprehensive examination of the natural history and characteristics of EBV infection,including its transmission routes,latent phases,and lytic replication processes.Additionally,we summarize the effects of environmental and genetic factors on EBV infection and EBV-associated diseases,including autoimmune conditions such as infectious mononucleosis,multiple sclerosis,and systemic lupus erythematosus,as well as malignancies like lymphoma,nasopharyngeal carcinoma,and gastric cancer.We particularly emphasize the crucial role of immune-related genetic factors,such as HLA genes,in the carcinogenicity of the virus.Furthermore,we discuss the crucial role of emerging biomarkers,including EBV serologic markers(such as VCA-IgA,EBNA1-IgA,BNLF2b)and cell-free nucleic acids(such as EBV DNA load and EBV DNA methylation),in clinical applications.Understanding the epidemiological characteristics of EBV infection is important for the prevention and management of EBV-associated diseases.In conclusion,this review provides robust epidemiological evidence to deepen the understanding of the etiology,pathogenesis,prevention and management strategies related to EBV-associated diseases.
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