Analysis of immune responses and clinical characteristics in relation to EBV DNA levels in children with infectious mononucleosis

ZHANG Shan-shan; ZHU Wei; GU Shao-qing

doi:10.13820/j.cnki.gdyx.20250782

Abstract：Objective To investigate the immune response in children with infectious mononucleosis(IM)and the correlation between their clinical characteristics and Epstein-Barr virus(EBV)DNA levels.Methods A total of 92 pediatric IM patients treated between May 2019 and May 2024 were enrolled.According to EBV-DNA load,patients were divided into a low-load group(≤105 copies/mL)and a high-load group(＞105 copies/mL).Peripheral blood EBV DNA levels were measured,and their correlation with clinical features and immune response indicators was analyzed.The relationship between Th1/Th2 immune balance and EBV DNA level was further explored.Results The incidence rates of eyelid edema,hepatosplenomegaly,and elevated viral load were significantly higher in the high EBV-DNA group than in the low-load group(P＜0.05).Levels of interferon-γ(IFN-γ),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),CD3+,and CD8+were significantly higher in the high-load group,while interleukin-4(IL-4),CD4+,and CD4/CD8 ratio were significantly lower compared to the low-load group(P＜0.05).Pearson correlation analysis showed positive correlations between EBV DNA load and IFN-γ,IL-2,TNF-α,IL-6,CD3+,and CD8+levels(r=0.366,0.217,0.424,0.522,0.288,0.343;allP＜0.05),and neg-ative correlations with IL-4,CD4+,and CD4/CD8 levels(r=-0.277,-0.394,-0.451;all P＜0.05).The IFN-γ/IL-4 and TNF-α/IL-4 ratios were higher in the high-load group(P＜0.05).Pearson correlation also re-vealed positive correlations of IFN-γ/IL-4 and TNF-α/IL-4 with CD3+and CD8+,and negative correlations with CD4+and CD4/CD8(all P＜0.05).Conclusion Clinical characteristics and immune responses in children with IM are closely associated with EBV DNA levels.High viral load leads to a Th1-biased shift in the Th1/Th2 immune balance.