scholarly journals Epidemiological investigation of hemophagocytic lymphohistiocytosis in China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shuyan Yao ◽  
Yini Wang ◽  
Yuan Sun ◽  
Li Liu ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Epstein Barr Virus ◽  
Age Of Onset ◽  
Epidemiological Investigation ◽  
Barr Virus ◽  
High Incidence ◽  
Regional Medical ◽  
Diagnosis Rate ◽  
Epstein Barr ◽  
And Gender

Abstract Background Currently, most research on hemophagocytic lymphohistiocytosis (HLH) have focused on etiology and therapy, leaving few epidemiological reports. The published studies of China are mainly regional investigations. We aimed to present the overall epidemiological status of HLH in China, and provide Chinese data for the international HLH epidemiological investigation. Methods The data of HLH cases in China in 2019 were collected and statistically analyzed. Findings Epstein-Barr virus accounted for 44.01% of the 1445 cases in 31 regions and was the most common cause. Lymphoma-associated HLH patients were more often male (P < 0.05) while rheumatic and immune-associated HLH were more often female (P < 0.001). Primary HLH and Epstein-Barr Virus-associated HLH were predominant in children (P < 0.001) while tumor-associated HLH was predominant in adults. Lymphoma-associated HLH was positively correlated with the age of onset (P < 0.01). The diagnosis rate of 29 areas had a significant correlation with per capita Gross domestic product (P < 0.05). Conclusion The different distribution of HLH etiology by age and gender contributes to the diagnosis of HLH by clinicians; The suboptimal diagnosis rate in regions with a high incidence of HLH in China is a result of the effect of the local economic level indicating the importance of improving the regional medical level.

scholarly journals Epidemiological Investigation of Hemophagocytic Lymphohistiocytosis in China

2021 ◽  
Author(s):  
Shuyan Yao ◽  
Yini Wang ◽  
Yuan Sun ◽  
Li Liu ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Epidemiological Investigation ◽  
Capita Gross Domestic Product ◽  
Common Cause ◽  
Economic Level ◽  
High Incidence ◽  
Regional Medical ◽  
Diagnosis Rate ◽  
Per Capita ◽  
Age And Sex

Abstract Background. At present, most research on HLH focus on etiology and therapy, leaving few epidemiological reports. The published studies of China are mainly regional investigations. We aim to present the overall epidemiological status of HLH in China, and provide Chinese data for the international HLH epidemiological investigation. Methods. The data of HLH cases in China in 2019 was collected and statistically analyzed. Findings. Among 1445 cases in 31 areas, EBV accounting for 44.01% is the most common cause. Lymphoma-associated HLH patients are mostly males (P<0.05) while rheumatic and immune-associated HLH mostly females (P<0.001). Children have mainly primary HLH and EBV-associated HLH (P<0.001) while adults mostly tumor-associated HLH. Lymphoma-associated HLH is positively correlated with the age of onset (P<0.01). The diagnosis rate of 29 areas has a significant correlation with per capita Gross domestic product (P<0.05). Conclusion. The etiology distribution of HLH in different age and sex is different, assisting clinicians with the diagnosis of HLH; The diagnosis rate of regions with a high incidence of HLH in China is not ideal as the result of the effect of the local economic level indicating the importance of improving the regional medical level.

Cost-Effectiveness of Nasopharyngeal Carcinoma Screening with Epstein-Barr Virus Polymerase Chain Reaction or Serology in High-Incidence Populations Worldwide

2020 ◽  
Author(s):  
Jacob A Miller ◽  
Quynh-Thu Le ◽  
Benjamin A Pinsky ◽  
Hannah Wang
Keyword(s):  
Cost Effectiveness ◽  
Epstein Barr Virus ◽  
Cost Effective ◽  
Chain Reaction ◽  
Men And Women ◽  
Barr Virus ◽  
Screening Strategies ◽  
High Incidence ◽  
Polymerase Chain ◽  
Epstein Barr

Abstract Background The incidence of endemic Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) varies considerably worldwide. In high-incidence regions, screening trials have been conducted. We estimated the mortality reduction and cost-effectiveness of EBV-based NPC screening in populations worldwide. Methods We identified 380 populations in 132 countries with incident NPC and developed a decision-analytic model to compare ten unique onetime screening strategies to no screening for men and women at age 50 years. Screening performance and the stage distribution of undiagnosed NPC were derived from a systematic review of prospective screening trials. Results Screening was cost-effective in up to 14.5% of populations, depending on the screening strategy. These populations were limited to East Asia, Southeast Asia, North Africa, or were Asian, Pacific Islander, or Inuit populations in North America. A combination of serology and nasopharyngeal polymerase chain reaction (PCR) was most cost-effective, but other combinations of serologic and/or plasma PCR screening were also cost-effective. The estimated reduction in NPC mortality was similar across screening strategies. For a hypothetical cohort of patients in China, 10-year survival improved from 71.0% (95%CI = 68.8%–73.0%) without screening to a median of 86.3% (range = 83.5%–88.2%) with screening. This corresponded to a median 10-year reduction in NPC mortality of 52.9% (range= 43.1%–59.3%). Screening interval impacted absolute mortality reduction and cost-effectiveness. Conclusions We observed decreased NPC mortality with EBV-based screening. Screening was cost-effective in many high-incidence populations and could be extended to men and women as early as age 40 years in select regions. These findings may be useful when choosing among local public health initiatives.

scholarly journals Fatal Septic Shock in a Patient with Hemophagocytic Lymphohistiocytosis Associated with an Infectious Mononucleosis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Giorgio Berlot ◽  
Ariella Tomasini ◽  
Lorenzo Zandonà ◽  
Eugenio Leonardo ◽  
Rossana Bussani ◽  
...  
Keyword(s):  
Septic Shock ◽  
Infectious Mononucleosis ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Epstein Barr Virus ◽  
Multiple Organ ◽  
Aggressive Lymphoma ◽  
Systemic Involvement ◽  
Barr Virus ◽  
Epstein Barr ◽  
Clinical Pictures

The authors describe the case of a young woman who developed a clinical pictures resembling a septic shock-related multiple organ dysfunction syndrome a couple of months after having been diagnosed suffering from a hemophagocytic lymphohistiocytosis associated with an infectious mononucleosis. Despite the aggressive treatment, which included antibiotics, vasopressors, IV immunoglobulins, and the use of an extracorporeal device aimed to remove mediators released both during sepsis and the cytokine storm determined by the hemophagocytic lymphohistiocytosis, the patient died. At the autopsy, an extremely uncommon aggressive lymphoma of Epstein-Barr virus-positive T-lymphocytes with systemic involvement was discovered.

Epstein-Barr virus and breast cancer: Serological study in a high-incidence area of nasopharyngeal carcinoma

2011 ◽  
Vol 309 (2) ◽  
pp. 128-136 ◽  
Author(s):  
Jian-Rong He ◽  
Lu-Ying Tang ◽  
Dan-Dan Yu ◽  
Feng-Xi Su ◽  
Er-Wei Song ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Serological Study ◽  
Barr Virus ◽  
High Incidence ◽  
Epstein Barr ◽  
High Incidence Area

scholarly journals The effect of Epstein – Barr Virus Viremia on the Progression to Severe COVID-19

2021 ◽  
Author(s):  
Jae Hyoung Im ◽  
Chung Hyun Nahm ◽  
Young Soo Je ◽  
Jin-Soo Lee ◽  
Hea Yoon Kwon ◽  
...  
Keyword(s):  
Epstein Barr Virus ◽  
Lymphocyte Subsets ◽  
Severe Pneumonia ◽  
Simplified Acute Physiology Score ◽  
Negative Group ◽  
Barr Virus ◽  
Saps Ii ◽  
High Incidence ◽  
Epstein Barr ◽  
Ebv Viremia

Abstract BackgroundCoronavirus disease 2019 (COVID-19) can reactivate several latent viruses. Epstein–Barr virus (EBV) is a latent virus that is frequently reactivated in patients with critical illnesses. Recently, a high incidence of viremia has been reported in patients with severe COVID-19. However, it is unclear whether EBV viremia is the result of the severity of COVID-19 or if it affects the severity of COVID-19. Therefore, we conducted a cohort study to evaluate the effects of EBV on the progression of COVID-19.MethodsWe compared the incidence of EBV viremia between the COVID-19 and non-COVID-19 groups. Simplified Acute Physiology Score (SAPS) II and lymphocyte subsets were analyzed in patients with COVID-19. We also observed that patients with COVID-19 with EBV viremia progressed to severe pneumonia more often than those without EBV viremia.ResultsTwo hundred and nine patients with COVID-19 were compared with the control (non-COVID-19) group. The incidence of EBV viremia was lower in the COVID-19 group than in the non-COVID-19 group (17.1% vs. 26.8%, P=0.034). In the subgroup analysis of the COVID-19 group, the EBV-positive group patients had more severe COVID-19 infection than the EBV-negative group (SAPS II, 22.3 vs. 17.4%; P=0.002). However, progression to moderate or severe pneumonia in patients with mild COVID-19 was rather high in the EBV-negative group (not statistically significant), contrary to our expectations.ConclusionsAlthough the severity of COVID-19 may affect EBV viremia, there is no evidence that EBV viremia is a factor that exacerbates pneumonia in patients with early COVID-19. The effect of EBV viremia on prolonged organizing pneumonia should be further studied.

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