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Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation

re: Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms

Real science is never settled, and anyone who has certainty on such things is not qualified to discuss it.

See my previous coverage of Long Haul COVID. Article follows below.

For reference, my own Epstein Barr Virus tests shown here. Tests show that what hit me in mid-June 2020 was almost certainly EBV reactivation.

   
2020-08-31 and 2021-03-22 test results for Epstein Barr Virus

Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation

17 June 2021. Emphasis added.

Epstein–Barr virus (EBV) is a human gamma herpesvirus. It is known to have infected and generally become latent in more than 90% of the global population [7], including more than 95% of healthy adults [8]. It is found at high rates in every region of the world. This is due to both its lifelong persistence in the latent state and because of its intermittent recrudescence in many latently infected individuals [9].

A variety of clinical manifestations have been associated with EBV reactivation. These include fatigue, psychoneurosis/brain fog, sleep disturbance, arthralgia, pharyngitis, myalgia, headaches, fever, gastrointestinal complaints, and various skin rashes [11]. We observed that many symptoms attributed to long COVID are the same as, or very similar to, those that have been associated with EBV reactivation.

...Results

An analysis of the 185 subjects who applied to our study, all of whom provided evidence of confirmed COVID-19 infections... We found that 66.7% (20/30) of long-term long COVID subjects versus 10% (2/20) of long-term control subjects were positive for EBV reactivation based on positive titers for EBV EA-D IgG or EBV VCA IgM. The difference in the fraction showing reactivation between the groups was found to be significant (p < 0.001, Fisher’s exact test)...
[WIND: p-value of 0.001 is highly signficant, 50 times better than the p=0.05 often used]

Two tests used to detect prior EBV infection in clinical practice, EBV VCA IgG and EBV nuclear antigen 1 (EBNA-1) IgG, return a positive result soon after primary EBV infection and typically remain positive for life. A positive result for both is typically indicative of past EBV infection. A positive result for EBV VCA IgG, but not for EBNA-1 IgG, may also indicate a past EBV infection in cases where patients were immunosuppressed or when individuals never produced EBNA-1 IgG at all [25]. EBV reactivation is typically identified by testing for the presence of EBV EA-D IgG or EBV VCA IgM [11,12,13].

...Subsequent to primary infection, EBV persists for a lifetime in the memory B lymphocytes of the infected host, albeit generally without pathological consequences on the individual. However, viral persistence can be associated with the development of cancer. More precisely, EBV is classified in group 1 of human carcinogens. It is the first human oncogenic virus to have been discovered and to this day, it remains the only human pathogen that can immortalize and transform cells in vitro...

WIND: I’m far more interested in an EBV vaccine than COVID vaccine, but none exists.

Main Targets of Interest for the Development of a Prophylactic or Therapeutic Epstein-Barr Virus Vaccine

Epstein-Barr virus (EBV) is one of the most widespread viruses in the world; more than 90% of the planet’s adult population is infected. Symptomatic primary infection by this Herpesviridae corresponds to infectious mononucleosis (IM), which is generally a benign disease.

While virus persistence is often asymptomatic, it is responsible for 1.5% of cancers worldwide, mainly B cell lymphomas and carcinomas. EBV may also be associated with autoimmune and/or inflammatory diseases. However, no effective treatment or anti-EBV vaccine is currently available.

Knowledge of the proteins and mechanisms involved in the different steps of the viral cycle is essential to the development of effective vaccines. The present review describes the main actors in the entry of the virus into B cells and epithelial cells, which are targets of interest in the development of prophylactic vaccines aimed at preventing viral infection. This review also summarizes the first vaccinal approaches tested in humans, all of which are based on the gp350/220 glycoprotein; while they have reduced the risk of IM, they have yet to prevent EBV infection...

The oncogenic potential of EBV precludes its being used in vaccinal projects in an attenuated or inactivated form. That is one reason why development of an anti-EBV vaccine presupposes optimal knowledge of the different elements contributing to the virus’s life cycle, namely the viral and cellular proteins implicated in the entry of the virus into host cells (prophylactic vaccines), and the proteins involved in viral persistence (therapeutic vaccines)...

...

WIND: could mRNA technology as used in the COVID vaccines be used to create an EBV vaccine? It might get tricky as it would have to avoid the cancer-inducing aspects of the virus.

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