| Popis: |
Background: Two types of Epstein Barr virus (EBV1/EBV2) have been shown to infect humans by causing infectious mononucleosis, their genome being very similar, except for regions of the EBNA genes. This study aimed to describe the EBV genotypes in cases of infectious mononucleosis in the metropolitan region of Belém, Brazil, from 2005 to 2016. Methods: A total of 8.295 suspected cases with symptoms/signs of infectious mononucleosis (MI) were investigated by doctors of infectious diseases at the Evandro Chagas Institute Health Care Service from January 2005 to December 2016. In 3.0% (251/8.295) of the cases were positive by enzymatic immunoassay were submitted to PCR for EBNA3C region to detect the types of EBV. Biochemical testing involving aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase were realized. Results: The identification of EBV types by PCR was verified in 30.3% (76/251) of individuals, being 71.1% (54/76) classified as EBV1, 17.1% (13/76) as EBV2 and 11.8% (9/76) as EBV1+EBV2. The number of women infected with EBV1 was higher (61.1% - 33/54) than for men (38.9% - 21/54), most were over 14 years old (66.7%-36/54). The main symptoms/clinical signs observed in EBV1 infection were: cervical lymphadenopathy (64.8%-35/54), fever (63%-34/54), headache (20.3%-11/54), arthralgia (20.3%-11/54) and exanthema (18.5%-10/54). In EBV2 infection, it was also detected in all age groups, with the exception of two groups, with an average age of 24 years. The presence of fever in 76.9% (10/13) with an average duration of 18 days and lymphadenopathy in 53.8 (7/13) were the most relevant signs/symptoms in EBV2. In contrast, EBV1+EBV2 co-infection was more frequent in the £5 year age group, affecting 20.0% (2/10). Women presented 66.7% (6/9) more positive cases. The symptoms involving EBV1+EBV2 co-infection were more related to fever (66.7%-6/9) and cervical lymphadenopathy (55.6% -5/9). The average of enzymatic values according to type of EBV was statistically significant (p |
