Background: To date, there is no commercially available vaccine to prevent infectious mononucleosis, a disease frequently induced by Epstein-Barr virus (EBV) infection in adolescents or adults devoid of preexisting immunity to the virus.
Methods: A total of 181 EBV-seronegative, healthy, young adult volunteers were randomized in a double-blind fashion to receive either placebo or a recombinant EBV subunit glycoprotein 350 (gp350)/aluminum hydroxide and 3-O-desacyl-4'-monophosphoryl lipid A (AS04) candidate vaccine in a 3-dose regimen.
Results: The vaccine had demonstrable efficacy (mean efficacy rate, 78.0% [95% confidence interval {CI}, 1.0%-96.0%]) in preventing the development of infectious mononucleosis induced by EBV infection, but it had no efficacy in preventing asymptomatic EBV infection. One month after receipt of the final dose of gp350 vaccine, 98.7% of subjects showed seroconversion to anti-gp350 antibodies (95% CI, 85.5%-97.9%), and they remained anti-gp350 antibody positive for >18 months. Furthermore, there were no concerns regarding the safety or reactogenicity of the gp350/AS04 vaccine.
Conclusion: These data support the clinical feasibility of using an EBV vaccine to prevent infectious mononucleosis.
Trial Registration: ClinicalTrials.gov identifier: NCT00430534.
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http://dx.doi.org/10.1086/523813 | DOI Listing |
BMJ Case Rep
January 2025
Department of Rheumatology, US Department of Veterans Affairs, Fresno, California, USA.
Castleman's disease (CD), also called angiofollicular lymphoid hyperplasia, is a rare lymphoproliferative illness with two unique variants: unicentric disease and multicentric disease (MCD). The multicentric variant is rare and presents as a systemic illness with symptoms like peripheral lymphadenopathy, splenomegaly, anaemia and systemic inflammatory symptoms. Given the vague and systemic presentation, this variant can be difficult to differentiate from infection and other autoimmune diseases.
View Article and Find Full Text PDFCureus
December 2024
Department of Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Melbourne, AUS.
Atraumatic splenic rupture (ASR) is a rare and life-threatening condition that presents diagnostic difficulties due to its rarity and non-specific clinical symptoms. It often requires computed tomography (CT) imaging for accurate diagnosis and surgical planning. Splenectomy is the standard treatment for unstable patients, but autotransplantation of splenic tissue may reduce the lifelong risks of overwhelming post-splenectomy infections (OPSI) by preserving some immunological function.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
Epstein-Barr virus (EBV) establishes persistent infection, causes infectious mononucleosis, is a major trigger for multiple sclerosis and contributes to multiple cancers. Yet, knowledge remains incomplete about how the virus remodels host B cells to support lytic replication. We previously identified that EBV lytic replication results in selective depletion of plasma membrane (PM) B cell receptor (BCR) complexes, composed of immunoglobulin and the CD79A and CD79B signaling chains.
View Article and Find Full Text PDFImmun Inflamm Dis
January 2025
Department of Pediatrics, NHO Okayama Medical Center, Okayama, Japan.
Aim: Kikuchi-Fujimoto disease (KFD) rarely affects pediatric patients and is characterized by prolonged fever and cervical lymphadenopathy. The diagnosis of KFD remains challenging and often requires an invasive biopsy. Low serum alkaline phosphatase levels have frequently been observed in patients with KFD; however, the clinical significance of low serum alkaline phosphatase levels remains unclear.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Guthrie Lourdes Hospital, Binghamton, USA.
Splenic infarction with infectious mononucleosis (IM) caused by Epstein-Barr Virus (EBV) has been reported as a rare complication of IM. The monospot test, often used to diagnose EBV-related IM, may produce false-negative results, especially in atypical presentations or early stages of infection. This report describes the case of a monospot-negative patient who developed splenic infarction as a complication of IM.
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