What is the role of Epstein-Barr Virus (EBV) and malaria infection in the etiology of Burkitt lymphoma/Burkitt-like lymphoma (BL/BLL)?

Updated: Dec 20, 2019
  • Author: Ali H Kanbar, MD; Chief Editor: Emmanuel C Besa, MD  more...
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EBV is a member of the herpesvirus family that has been strongly implicated in the endemic form of Burkitt lymphoma (eBL). Virtually all patients with eBL are EBV positive, whereas only about 20% of sporadic (sBL) cases are associated with EBV. EBV tends to cause a latent infection of B lymphocytes, some of which evade the T-cell-mediated immune response and enter the germinal center. This subsequently results in excessive B cell proliferation. [2]

Malaria infection also probably plays a role in the pathogenesis of eBL, as it can lead to inhibition of EBV-specific immune response. [2] The exact mechanism of EBV-mediated lymphomagenesis, however, is not well understood, but evidence exists for a significant interaction between viral and cellular microRNA (miRNA) interfering with normal gene expression and translation. [12] EBV can be detected in 25-40% of immunodeficiency-associated cases. [2]

EBNA-1 (EBV nuclear antigen-1) and EBV-encoded RNAs have been shown to possess modest anti-apoptotic properties. Furthermore, EBNA-3A and EBNA-3C can inhibit the expression of the anti-apoptotic protein BCL-2. [13]

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