爱泼斯坦 - 巴尔病毒感染的流行病学和临床特征的分析

爱泼斯坦 - 巴尔病毒（EBV）负责一系列人类疾病，并在各种人群中表现出了相当大的流行。分子流行病学研究的进步增强了我们对EBV相关病理学的理解。在这项研究中，我们的目标是检查中国重庆EBV感染的流行病学特征和临床特征。我们招募了涉嫌与EBV相关疾病的患者，他们在2013年5月至2022年11月之间被录取到重庆医科大学第一家附属医院。纳入标准是基于接受EBV特异性免疫荧光或Plasma EBV-DNA测试的人。在13 584个住院患者中，EBNA-1-IGG，EBV-VCA-IGM，EBV-EA-IGG，EBV-EA-IGG，EBV-EA-IGA，EBV-VCA-IGA和EBV-DNA的总体血清阳性率为91.89％，7.22％，7.22％，18.00％，18.00％，16.19％，16.19％，30.78％和18.78％和18.78％和18.78％和18.78％和18.78％和18.78％和18.78％和18.00％000.00％和18.78％和18.00％000％和18.78％和18.00％000％000％和18.78％和18.78％和18.00％000％000％和18.78％和18.00％000％000.00％相分为二。 EBNA-1-IGG的血清阳性速率随着年龄的增长而稳步增加。 VCA-IGM的血清阳性率是急性EBV感染的指标，年龄在11-20岁的患者中，为26.41％，老年患者的血清阳性率最高，降至2％-6％。此外，在205名门诊患者中，EBV-DNA阳性率为14.15％。在3670名健康检查中心的人中，EBV-EA-IGA和EBV-VCA-IGA的血清阳性率分别为11.96％和28.09％，EBV-DNA阳性率为11.92％，所有这些阳性率为11.92％，所有这些阳性率分别低于内科患者中的EBV-DNA阳性率。在762个EBV-DNA阳性住院医师中，年龄31-40岁的成年人受到影响最小，血清阳性率为12.00％，随着年龄的增长而增加。与原发性EBV感染相关的最常见疾病是感染性单核细胞增多症（IM）（35.49％），其次是EBV感染（14.15％）和肺炎（7.19％）。与EBV重新激活有关的最常见疾病是肺炎（16.80％），鼻咽癌（NPC）（11.02％）和自身免疫性疾病（7.04％）。淋巴细胞淋巴病细胞增多症（HLH）的患者的病毒载量最高，明显高于NPC，肺炎和肝肝硬化患者。这项大规模回顾性研究探讨了所有年龄段的EBV感染的流行病学特征和疾病谱。这些发现有助于改善EBV感染的诊断和管理策略。

The Epstein-Barr virus (EBV) is responsible for a spectrum of human diseases and demonstrates a considerable prevalence among various populations. Advances in molecular epidemiological research have enhanced our comprehension of EBV-related pathologies. In this study, our objective was to examine the epidemiological profile and clinical features of EBV infection in Chongqing, China. We enrolled patients suspected of EBV-related diseases who were admitted to the First Affiliated Hospital of Chongqing Medical University between May 2013 and November 2022. Inclusion criteria were based on those who underwent EBV-specific immunofluorescence or plasma EBV-DNA testing. Among 13 584 inpatients, the overall seropositivity rates for EBNA-1-IgG, EBV-VCA-IgM, EBV-EA-IgG, EBV-EA-IgA, EBV-VCA-IgA, and EBV-DNA were 91.89%, 7.22%, 18.00%, 16.19%, 30.78%, and 18.00%, respectively. The seropositivity rate for EBNA-1-IgG steadily increased with age. The seropositivity rate for VCA-IgM, an indicator of acute EBV infection, was highest in patients aged 11-20 years at 26.41%, decreasing to 2%-6% in older patients. Additionally, among 205 outpatients, the EBV-DNA positivity rate was 14.15%. In 3670 individuals from health check-up centers, the seropositivity rates for EBV-EA-IgA and EBV-VCA-IgA were 11.96% and 28.09%, respectively, and the EBV-DNA positivity rate was 11.92%, all of which were lower than those in inpatients. Among the 762 EBV-DNA positive inpatients, adults aged 31-40 years were the least affected, with a seropositivity rate of 12.00%, which increased with age. The most common diseases associated with primary EBV infection were infectious mononucleosis (IM) (35.49%), followed by EBV infection (14.15%) and pneumonia (7.19%). The most common diseases associated with EBV reactivation were pneumonia (16.80%), nasopharyngeal carcinoma (NPC) (11.02%), and autoimmune diseases (7.04%). Patients with hemophagocytic lymphohistiocytosis (HLH) had the highest viral load, significantly higher than those with NPC, pneumonia, and liver cirrhosis. This large-scale retrospective study explores the epidemiological characteristics and disease spectrum of EBV infection across all age groups. The findings contribute to the improvement of diagnostic and management strategies for EBV infection.