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Hodgkin’s Lymphoma
associated Epstein-Barr
Virus (EBV) infection
SIDDHESH U. SAPRE
ROLL NUMBER- 17
M.SC. VIROLOGY – PART I
NATIONAL INSTITUTE OF VIROLOGY (NIV), PUNE
Epstein Barr
Virus/ HHV-4
Tegument Family: Herpesviridae
Subfamily:
Gammaherpesvirinae
Genus:
Lymphocryptovirus
Nucleic acid:
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
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)
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……………………!
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)
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,)
Classical HD
has 4 subtypes
Mixed
cellularity HD
Lymphocyte
rich HD
Nodular
sclerosis HD
Lymphocyte
depleted HD
People who have had infectious mononucleosis (mono),an infection caused by the Epstein-Barr virus
(EBV), have an increased risk of Hodgkin disease.
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)
Treatment of HD:
 Radiation therapy (involved site/ involved field )
 PBSCT, BMT
 Chemotherapy for HD:
o Adriamycin (doxorubicin)
o Bleomycin
o Vinblastine
o Dacarbazine (DITC)
o Generally ABVD and BEACOPP regimens are used
o mAb therapy (Brentuximab vedotin, Rituximab)
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
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
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
THANKS!!!
QUESTIONS?????

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HODGKIN'S DISEASE ASSOCIATED EPSTEIN BARR VIRUS INFECTION

  • 1. Hodgkin’s Lymphoma associated Epstein-Barr Virus (EBV) infection SIDDHESH U. SAPRE ROLL NUMBER- 17 M.SC. VIROLOGY – PART I NATIONAL INSTITUTE OF VIROLOGY (NIV), PUNE
  • 2. Epstein Barr Virus/ HHV-4 Tegument Family: Herpesviridae Subfamily: Gammaherpesvirinae Genus: Lymphocryptovirus Nucleic acid: 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
  • 3. 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)
  • 4.
  • 5. 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……………………!
  • 6. 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)
  • 7. 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,)
  • 8. Classical HD has 4 subtypes Mixed cellularity HD Lymphocyte rich HD Nodular sclerosis HD Lymphocyte depleted HD
  • 9.
  • 10. People who have had infectious mononucleosis (mono),an infection caused by the Epstein-Barr virus (EBV), have an increased risk of Hodgkin disease.
  • 11. 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)
  • 12. Treatment of HD:  Radiation therapy (involved site/ involved field )  PBSCT, BMT  Chemotherapy for HD: o Adriamycin (doxorubicin) o Bleomycin o Vinblastine o Dacarbazine (DITC) o Generally ABVD and BEACOPP regimens are used o mAb therapy (Brentuximab vedotin, Rituximab)
  • 13. 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
  • 14. 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
  • 15. 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