Epstein‐barr virus‐infected b cells persist in the circulation of acyclovir‐treated virus carriers

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Abstract
In this study, infectious Epstein‐Barr virus (EBV) shedding in the oropharynx and numbers of virus‐infected B cells in the blood have been monitored in long‐term virus carriers receiving acyclovir (ACV) therapy for herpes zoster. Eleven patients on oral ACV were followed prospectively before, during and for 2 weeks after treatment. As expected, the low levels of EBV shedding in these virus carriers (measured as cord‐blood lymphocyte transforming activity in throat washings) were eliminated during the period of ACV treatment and returned at later times. Over the same period, however, the frequency of virus‐infected B cells in the blood (measured by spontaneous transformation in limiting dilution assay) remained completely unchanged. Regression assays showed that these same patients had normal levels of EBV‐specific cytotoxic T‐cell immunity, so that the in vivo persistence of virus‐infected B cells could not be ascribed to a defect in T‐cell surveillance. We infer that the in vivo half‐life of the virus‐infected B‐cell pool in long‐term virus carriers is measured in months rather than days. We further suggest that such persistence requires a novel form of virus: B‐cell interaction distinct from the type of “latent” infection displayed by in vitro‐transformed cells.