hodgkin's disease associated epstein barr virus infection
TRANSCRIPT
![Page 1: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/1.jpg)
Hodgkin’s Lymphoma associated Epstein-Barr Virus (EBV) infectionSIDDHESH U. SAPREROLL NUMBER- 17M.SC. VIROLOGY – PART INATIONAL INSTITUTE OF VIROLOGY (NIV), PUNE
![Page 2: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/2.jpg)
Epstein Barr Virus/
HHV-4
Tegument Family: Herpesviridae
Subfamily: Gammaherpesviri
naeGenus:
Lymphocryptovirus
Nucleic acid: Linear, double stranded DNA
(184 kbp)
Enveloped, Spherical or pleomorphic
Icosahedral symmetry
Modes of transmission:1. Exposure to infected body secretions
2. Respiratory tract and mucous membranes
3. Parenteral exposure (transfusion) rare
![Page 3: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/3.jpg)
Structure and infectious cycle(EBV):
viral envelope glycoprotein gp350/220
cellular receptor for the C3d complement component CR2 (CD 21)
gp25, gp42 & gp85
B-lymphocyte (APC)
![Page 4: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/4.jpg)
![Page 5: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/5.jpg)
EBV is an etiological agent for:
1. Infectious mononucleosis 2. Hodgkin’s lymphoma (after
Dr.Thomas Hodgkin) 3. Burkitt’s lymphoma 4. AIDS-related lymphoma 5. Post-transplant
lymphoproliferative disease (PTLD) 6. Nasopharyngeal carcinoma Let’s explore Hodgkin’s lymphoma
now……………………!
![Page 6: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/6.jpg)
Hodgkin’s lymphoma
Lymphoid tissue is present throughout the body HD can start practically anywhere inside the body (most often starts in the lymph nodes in the upper part of the body)
Sites: in the neck, in the chest or under the arm Most often spreads through the lymph nodes in a
stepwise fashion from lymph node to lymph node In the late stage (rare), it invades the blood stream and
spreads throughout the body (liver, lungs, and bone marrow)
![Page 7: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/7.jpg)
Types of Hodgkin’s disease (appearance under microscope) Classical HD (95% case in the world) Reed-Sternberg cells (abnormal type
of B lymphocyte, much larger than normal lymphocytes,)
![Page 8: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/8.jpg)
Classical HD has 4 subtypes
Mixed cellularity
HD Lymphocyte
rich HD Nodular sclerosis
HD
Lymphocyte depleted
HD
![Page 9: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/9.jpg)
![Page 10: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/10.jpg)
People who have had infectious mononucleosis (mono),an infection caused by the Epstein-Barr virus (EBV), have an increased risk of Hodgkin disease.
![Page 11: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/11.jpg)
Signs and symptoms of HD:
Lumps under the skin Cough, trouble breathing, chest pain General (non-specific) symptoms/ B
symptoms: Fever without an infection Drenching night sweats Weight loss of the body (unintentional,
more than 10% of the body weight in about 6 months)
![Page 12: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/12.jpg)
Treatment of HD:
Radiation therapy (involved site/ involved field ) PBSCT, BMT Chemotherapy for HD:o Adriamycin (doxorubicin)o Bleomycino Vinblastineo Dacarbazine (DITC)o Generally ABVD and BEACOPP regimens are usedo mAb therapy (Brentuximab vedotin, Rituximab)
![Page 13: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/13.jpg)
Factors that show the presence of EBV infection in B lymphocytes
fluorescent situ hybridisation technique to detect EBV DNA (EBER1 & EBER 2) sequences (latent infection in situ) ( GOLD Std. for Clinical
samples) Also express high levels of (EBNA), (LMP) LMP (CD23 & CD40) IL-10 production , upregulation of ICAM, Lymphocyte Function associated
Antigen (LFA), downregulation of CD99 Protects B cells from cell death by upregulation of several anti-apoptotic
genes including bcl-2, mcl-1 and A-20
![Page 14: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/14.jpg)
Treatment of Epstein Barr Virus infections
no vaccine protected by close physical contact, food, or personal items,
like toothbrushes, with people who have EBV infection
![Page 15: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/15.jpg)
To summarise:
Epstein Barr virus is associated with about 37% of the cases of all lymphomas- including the Hodgkin’s disease
Early EBV infection associated with immunocompromised status or transplantation/ transfusions can increase the risk of EBV infections causing lymphoma
In about 90% of the cases which are infected with EBV, it remains latent throughout the life cycle of the subject and doesn’t lead to malignancies
Hodgkin’s lymphoma is curable even in the late state of malignancy
![Page 16: HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION](https://reader035.vdocuments.mx/reader035/viewer/2022062522/58a067bc1a28ab06528b53b9/html5/thumbnails/16.jpg)
THANKS!!!
QUESTIONS?????