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Neutralizing Antibody Titers Increase over Many Months to Years after Epstein-Barr Virus Infectious Mononucleosis

Wednesday, October 10, 2012 — Poster Session II

Noon – 2:00 p.m

Natcher Conference Center, Building 45




  • W. Bu
  • D.O. Schmeling
  • P.D. Burbelo
  • H.H. Balfour
  • J.I. Cohen


Primary infection of Epstein-Barr virus (EBV) causes infectious mononucleosis in adolescents and young adults. Symptoms of mononucleosis usually resolve in 1 to 2 months, but the severity and length of illness varies among patients. While neutralizing antibody has been detected in persons with EBV infectious mononucleosis, few studies have followed patients prospectively and titers of neutralizing antibodies were reported to peak within 2 months after infection. In this study, we used a highly quantitative, flow cytometry based, EBV neutralization assay that directly measures the ability of antibody to prevent infection of B cells. Neutralizing antibodies were absent before infection, but were detected as early as 14 days after onset of symptoms. The median peak in the neutralization titer was 1 year after onset of symptoms; 3 subjects had peak titers more than 2.5 years after symptoms. No clear correlation was found between the severity of symptoms and the peak level of neutralizing antibody. We are currently quantifying the levels of antibodies to EBV proteins. In summary, we found that the development of high titer neutralizing antibody to EBV is a very slow process, which often requires a year or more and occurs long after symptoms of infectious mononucleosis have resolved.

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