Epstein-Barr virus burden in adolescents with systemic lupus erythematosus

Ben Z Katz*, Babak Salimi, Sue Kim, Phyllis Nsiah-Kumi, Linda Wagner-Weiner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective. We sought to determine whether patients with systemic lupus erythematosus (SLE) and a presumed primary or reactivated Epstein-Barr virus (EBV) serologic response had evidence of an active EBV infection. Background. Patients with SLE often have what appears to be a primary or reactivated EBV serologic response. If these patients then present with fever, fatigue, adenopathy or leukopenia, it is not clear whether these symptoms are caused by worsening SLE or EBV infection. Establishing the correct diagnosis is crucial for management. Methods. We examined the EBV burden in 13 adolescents with SLE and a presumed primary or reactivated EBV serologic response. All were taking prednisone; 2 each were also on azathioprine or intravenous pulse cyclophosphamide. EBV serologies were performed for all, and EBV burdens were assessed via immortalization assays and EBV DNA amplification of blood and saliva at least once. Results. Seven patients had serologic patterns indicative of a primary EBV infection, while six had serologies indicative of a reactivated (secondary) EBV infection. Two of the latter were the only ones in whom a small amount of biologically active EBV was detected. Conclusion. In our series active EBV infection was not seen in most patients, despite serologic data that could be interpreted as a primary or reactivated infection. Thus the serologic profiles were more likely a consequence of immune dys-regulation secondary to SLE or its therapy rather than rampant infection with EBV.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalPediatric Infectious Disease Journal
Issue number2
StatePublished - Feb 24 2001


  • Antibodies
  • Human herpesvirus-4
  • Serology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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