Interferon-alpha therapy for chronic active Epstein-Barr virus infection: potential effect on the development of T-lymphoproliferative disease.

PURPOSE: A patient with aggressive chronic active Epstein-Barr virus (CAEBV) infection is described whose disease activity subsided after interferon (IFN)-alpha therapy.

PATIENT AND

METHODS

The patient had intermittent fever, cytopenia, liver dysfunction, hepatosplenomegaly, abnormal titers of EBV-associated antibodies, and positive EBV genomes.

RESULTS

Despite repeated trials of the antiviral agents prednisolone and gamma-globulin, his condition deteriorated. The administration of IFN-alpha (1 x 10(5) U/kg subcutaneously 3 times per week) led to a dramatic clinical improvement. During the IFN-alpha therapy, the rearrangement bands of T-cell antigen receptor genes disappeared assessed by Southern blotting with a decrease in the number of activated T cells, although the EBV-genome remained evident.

CONCLUSIONS

These observations suggest that IFN-alpha is useful in managing CAEBV, possibly restraining the clonal development of T-lymphoproliferative disease (LPD) and EBV-associated B-LPD, although it does not eradicate the proliferation of EBV.