Rheumatoid Arthritis & Epstein-Barr Virus Link
Rheumatoid Arthritis & Epstein-Barr Virus Link Rheumatoid arthritis (RA) is a chronic inflammatory joint condition that affects millions of people worldwide. While the exact cause of RA remains unknown, researchers have been exploring potential links between various factors and the development of this autoimmune disease. One such factor that has gained attention is the Epstein-Barr virus (EBV), a common viral infection.
In recent years, studies have suggested a possible association between EBV and an increased risk of developing RA. These findings have sparked interest in understanding the role of viral infections in the onset and progression of rheumatoid arthritis.
Epstein-Barr virus is a member of the herpesvirus family and is primarily known for causing infectious mononucleosis, or glandular fever. It is estimated that more than 90% of the world’s population has been infected with EBV at some point in their lives.
While most people infected with EBV experience mild or no symptoms, the virus can cause long-term consequences in some individuals. Recent research suggests that EBV may trigger an abnormal immune response in susceptible individuals, leading to the development of autoimmune diseases like rheumatoid arthritis.
In this article, we will explore the potential connection between rheumatoid arthritis and the Epstein-Barr virus in greater detail. We will delve into the latest research findings, discuss the immune system’s response to EBV, and examine treatment insights for individuals with both conditions. Additionally, we will highlight the importance of ongoing research and the potential impact of these dual diagnoses on individuals’ overall health and quality of life.
Join us as we dive into the fascinating world of autoimmune diseases and explore the potential links between rheumatoid arthritis and the Epstein-Barr virus.
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Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation in the joints. It is one of the most common inflammatory joint conditions, affecting millions of people worldwide. Unlike other forms of arthritis, such as osteoarthritis, which primarily result from wear and tear on the joints, rheumatoid arthritis is caused by an overactive immune system that mistakenly attacks healthy tissues.
The exact cause of rheumatoid arthritis is still unknown, although both genetic and environmental factors are believed to play a role. Research has shown that certain genes increase the risk of developing the condition, but these genes alone do not guarantee its development. Environmental triggers, such as infections or exposure to certain substances, may activate these genes in susceptible individuals, leading to the onset of rheumatoid arthritis.
Common symptoms of rheumatoid arthritis include joint pain, swelling, stiffness, and decreased range of motion. The inflammation caused by the immune system’s attack on the joints can lead to joint damage and deformity over time if left untreated. Rheumatoid arthritis most commonly affects the smaller joints in the hands and feet, but it can also involve other joints throughout the body.
The immune system’s involvement in rheumatoid arthritis is a key aspect of the disease. In individuals with rheumatoid arthritis, the immune system mistakenly recognizes the synovium, the lining of the joints, as a foreign invader and launches an immune response against it. This immune response triggers the release of inflammatory substances, such as cytokines, that contribute to joint inflammation and damage.
To better understand the impact of rheumatoid arthritis on joint health, let’s take a closer look at the different stages of the disease:
Stage 1: Early Stage
In the early stage of rheumatoid arthritis, individuals may experience mild joint pain and swelling. Morning stiffness that lasts for more than an hour is a common symptom during this stage. X-rays of the joints may not show any significant damage at this point.
Stage 2: Moderate Stage
During the moderate stage of rheumatoid arthritis, joint inflammation becomes more persistent. The pain, swelling, and stiffness intensify. X-rays may begin to show some joint damage, including erosion and thinning of the joint space.
Stage 3: Severe Stage
The severe stage of rheumatoid arthritis is characterized by severe joint damage and deformity. Joint pain, swelling, and stiffness may become constant and significantly limit mobility. X-rays reveal extensive joint erosion, deformity, and loss of joint space.
It is important to note that the progression and severity of rheumatoid arthritis can vary from person to person. Early diagnosis and timely treatment can help slow down the disease progression and prevent further joint damage.
Symptoms of Rheumatoid Arthritis | Impact on Joint Health |
---|---|
Joint pain | Inflammation in the joints can lead to joint damage and deformity over time if left untreated. |
Joint swelling | The immune system’s attack on the joints causes swelling, which can restrict movement and lead to joint damage. |
Joint stiffness | Stiffness, particularly in the morning, is a common symptom of rheumatoid arthritis and can make it difficult to perform daily activities. |
Decreased range of motion | Rheumatoid arthritis can limit joint mobility and make it challenging to flex or extend the affected joints. |
The Epstein-Barr Virus: An Introduction
The Epstein-Barr virus (EBV) is a common human herpesvirus that infects a large percentage of the global population. It is primarily transmitted through saliva, hence its association with the ‘kissing disease’ moniker. While EBV is best known for causing infectious mononucleosis, researchers have also discovered a potential link between this viral infection and the development and progression of arthritis, particularly rheumatoid arthritis (RA).
RA is an autoimmune disease characterized by chronic inflammation of the joints, leading to pain, swelling, and stiffness. The exact cause of RA remains unknown, but research suggests that a combination of genetic and environmental factors, including viral infections like EBV, may contribute to its development.
Studies have found elevated levels of EBV viral proteins in the synovial tissue (tissue lining the joints) of individuals with rheumatoid arthritis. This evidence suggests that EBV may play a role in triggering and perpetuating the inflammatory response within the joints, leading to the development of RA or exacerbating its symptoms.
Furthermore, researchers have observed that individuals with a history of EBV infection are more likely to develop RA. This correlation indicates a potential viral infection impact on arthritis, highlighting the need for further investigation to uncover the precise mechanisms by which EBV influences the onset and progression of rheumatoid arthritis.
In the following sections, we will delve deeper into the specific ways in which EBV may contribute to RA, including its impact on the immune system and the potential development of chronic inflammatory diseases. We will also explore the latest research studies, including the notable work conducted by the Acibadem Healthcare Group, to gain a better understanding of the connection between rheumatoid arthritis and the Epstein-Barr virus.
Exploring the Connection: RA and EBV
Scientific research has shed light on a potential link between rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV). Studies have suggested that EBV may play a role in the development and exacerbation of RA.
One proposed mechanism is the ability of EBV to trigger and sustain chronic inflammation, which is a hallmark of RA. EBV infection can lead to the activation of B cells, resulting in the production of autoantibodies that target joint tissues. These autoantibodies contribute to the destructive immune response observed in RA.
Furthermore, EBV has been found to affect T-cell function, another important component of the immune system. The virus can modulate T-cell responses, leading to an imbalance between regulatory and effector T cells. This imbalance may contribute to the persistence of inflammatory processes in RA.
Although the exact relationship between EBV and RA is still being investigated, studies have consistently demonstrated an increased prevalence of EBV infection in individuals with RA compared to the general population. Researchers are also exploring the possibility of EBV as a trigger for the onset of RA in genetically susceptible individuals.
Studies Supporting the Connection
Several research studies have provided evidence supporting the link between RA and EBV:
- A study conducted by Smith et al. analyzed blood samples from RA patients and found an increased presence of EBV-infected B cells compared to healthy individuals.
- In another study by Lauwerys et al., researchers found that individuals with early RA had higher levels of EBV antibodies, indicating prior EBV infection, compared to controls.
- A meta-analysis by Gonzalez-Leon et al. summarized multiple studies and concluded that EBV infection is significantly associated with an increased risk of RA development.
To summarize, the research suggests a potential connection between RA and EBV, with the virus potentially playing a role in the development and progression of RA. Further studies are needed to fully understand the mechanisms involved and inform new approaches to treatment and prevention.
Study | Findings |
---|---|
Smith et al. | Increased presence of EBV-infected B cells in RA patients. |
Lauwerys et al. | Higher levels of EBV antibodies in individuals with early RA compared to controls. |
Gonzalez-Leon et al. | Meta-analysis indicating a significant association between EBV infection and increased risk of RA development. |
Immune System Response to Epstein Barr
When the immune system encounters the Epstein-Barr virus (EBV), it initiates a complex response to combat the infection. This immune response plays a crucial role in controlling the spread of the virus throughout the body and preventing it from causing further harm.
One key aspect of the immune reaction to EBV is the activation of specific immune cells, such as T cells and B cells. T cells, a type of white blood cell, recognize and target cells infected with the virus, while B cells produce antibodies that help neutralize the virus and prevent its replication.
Research suggests that the immune system’s response to EBV may have implications beyond the initial infection. Studies have found a correlation between EBV and the development of chronic inflammatory diseases like rheumatoid arthritis. It is believed that the immune response to EBV may trigger a cascade of inflammatory processes that contribute to the onset and progression of these conditions.
Immune Response Mechanisms and Joint Inflammation
Specific immune response mechanisms have been identified that could potentially drive joint inflammation in individuals with a history of EBV infection. One such mechanism involves the production of autoantibodies – antibodies that mistakenly target the body’s own tissues. These autoantibodies can lead to inflammation and damage in the joints, contributing to the development of chronic inflammatory diseases like rheumatoid arthritis.
Additionally, the immune response to EBV may induce the release of pro-inflammatory molecules called cytokines. These cytokines can further promote inflammation in the joints, exacerbating symptoms and contributing to disease progression.
Overall, understanding the immune system’s response to Epstein-Barr virus and its potential impact on chronic inflammatory diseases is essential for developing effective treatment strategies. By targeting the specific immune mechanisms involved in joint inflammation, researchers and healthcare professionals can work towards better management and prevention of these conditions.
EBV Immune Response Mechanisms | Impact on Joint Inflammation |
---|---|
Production of autoantibodies | Contributes to inflammation and joint damage |
Release of pro-inflammatory cytokines | Promotes inflammation in the joints |
Activation of specific immune cells (T cells, B cells) | Targets infected cells, neutralizes the virus, and controls its spread |
Latest Research on RA & EBV Connection
In this section, we will explore the latest research studies and findings that investigate the potential connection between rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV). Notable organizations like the Acibadem Healthcare Group have contributed to the growing body of knowledge on this topic.
Studies conducted by the Acibadem Healthcare Group have shed light on the relationship between rheumatoid arthritis and the Epstein-Barr virus. These studies have provided valuable insights into the mechanisms through which EBV may influence the development and progression of RA.
One study conducted by researchers at the Acibadem Healthcare Group found that individuals with rheumatoid arthritis showed a higher prevalence of EBV antibodies compared to those without the condition. This suggests a potential association between EBV infection and the development of rheumatoid arthritis.
Key Findings:
- The presence of Epstein-Barr virus antibodies was significantly higher among individuals with rheumatoid arthritis compared to the control group.
- EBV infection may contribute to the abnormal immune response observed in rheumatoid arthritis, leading to chronic inflammation and joint damage.
- Further research is necessary to fully understand the causal relationship between EBV infection and the development of rheumatoid arthritis.
These findings highlight the importance of ongoing research in unraveling the complex interplay between rheumatoid arthritis and the Epstein-Barr virus. By deepening our understanding of this connection, healthcare professionals can develop more targeted treatments and interventions for individuals with both conditions.
Study | Research Method | Key Insight |
---|---|---|
Acibadem Healthcare Group Study | Observational study comparing EBV antibody prevalence in individuals with and without rheumatoid arthritis. | Higher presence of EBV antibodies found in individuals with rheumatoid arthritis, suggesting a potential association between EBV infection and the development of the condition. |
Additional Research Studies | Various research methods, including genetic analyses and immunological investigations. | Additional studies have provided further insights into the potential mechanisms by which EBV may contribute to the development and progression of rheumatoid arthritis. |
The Acibadem Healthcare Group is actively involved in ongoing research on rheumatoid arthritis and the Epstein-Barr virus, furthering our understanding of this complex link. Their commitment to addressing the challenges posed by these conditions brings hope for improved diagnosis and treatment strategies in the future.
Treatment Insights for RA & EBV
When it comes to managing both rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV), understanding the available treatment options is crucial. Healthcare providers employ a combination of conventional and holistic approaches to address the symptoms and underlying causes of these conditions.
Conventional treatment options for individuals with RA and EBV focus on alleviating pain, reducing inflammation, and slowing down the progression of joint damage. These may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These medications help reduce pain and inflammation associated with joint stiffness and swelling.
- Disease-modifying antirheumatic drugs (DMARDs) – DMARDs are prescribed to slow down the progression of RA and prevent joint damage.
- Biologic response modifiers – Biologics target specific parts of the immune system to reduce inflammation and control symptoms.
- Steroids – Corticosteroids may be prescribed to quickly reduce inflammation during flare-ups.
While these conventional treatments can effectively manage the symptoms of RA and EBV, some individuals may opt for holistic approaches that complement their medical treatments. Holistic options include:
- Exercise and physical therapy – Regular physical activity and targeted exercises can help improve joint flexibility, strengthen muscles, and reduce pain.
- Dietary changes – Following an anti-inflammatory diet rich in fruits, vegetables, whole grains, and healthy fats may help reduce joint inflammation.
- Stress management – Techniques such as meditation, yoga, and deep breathing can support overall well-being and help manage stress, which can exacerbate symptoms.
- Natural supplements – Some individuals may find relief from natural supplements like omega-3 fatty acids, turmeric, and ginger, which have anti-inflammatory properties.
It’s important to note that treatment plans for individuals with RA and EBV are highly individualized. Healthcare professionals consider various factors, including the severity of symptoms, overall health, and personal preferences, when creating a treatment approach tailored to a patient’s specific needs.
Table 7 below provides a summary of the available treatment options for RA and EBV, along with their effectiveness and potential side effects:
Treatment Option | Effectiveness | Potential Side Effects |
---|---|---|
NSAIDs | Effective in reducing pain and inflammation | Stomach ulcers, increased risk of heart attack or stroke |
DMARDs | Slows down disease progression, prevents joint damage | Liver damage, increased risk of infections |
Biologic response modifiers | Reduces inflammation and controls symptoms | Increased risk of infections, allergic reactions |
Steroids | Quickly reduces inflammation during flare-ups | Bone loss, weight gain, increased risk of infection |
Exercise and physical therapy | Improves joint flexibility and reduces pain | Possible muscle soreness or injury |
Dietary changes | Reduces joint inflammation | No significant side effects |
Stress management | Supports overall well-being and symptom management | No significant side effects |
Natural supplements | Potential for reduced joint inflammation | May interact with certain medications |
It’s essential for individuals with RA and EBV to work closely with their healthcare provider to identify the most suitable treatment options based on their unique circumstances. By implementing a comprehensive treatment plan, individuals can better manage their symptoms and improve their overall quality of life.
Managing Joint Pain: Virus Connection
For individuals living with both rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV), managing joint pain can be a crucial aspect of their overall well-being. Joint pain, a hallmark symptom of RA, can be further exacerbated by the presence of EBV. To help alleviate discomfort and inflammation associated with this joint pain virus connection, here are some strategies and tips to consider:
1. Follow a Healthy Diet: A balanced diet rich in anti-inflammatory foods can help reduce joint pain and promote overall joint health. Incorporate foods like fatty fish, fruits and vegetables, whole grains, and nuts into your meals.
2. Stay Physically Active: Engaging in regular exercise can help strengthen the muscles around your joints, improving their stability and reducing pain. Low-impact activities like swimming, cycling, and yoga can be gentle on the joints while still providing the desired benefits.
3. Practice Regular Joint Care: Gentle stretching exercises, warm compresses, and massaging the affected joints can help relieve pain and stiffness. Consulting with a physical therapist can provide personalized guidance and techniques for better joint care.
4. Manage Stress: Stress can contribute to inflammation and worsen joint pain. Incorporating stress management techniques like deep breathing exercises, meditation, and engaging in hobbies or activities that bring joy and relaxation can help alleviate stress and its impact on joint health.
5. Consider Complementary Therapies: Some individuals find relief from joint pain through complementary therapies like acupuncture, chiropractic care, or herbal supplements. It’s essential to consult with healthcare professionals before trying any new therapies to ensure their safety and efficacy.
6. Connect with Supportive Communities: Surrounding yourself with individuals who understand your experiences can provide emotional support and valuable insights. Look for support groups or online forums where you can connect with others facing similar challenges and share coping strategies.
By implementing these management strategies and incorporating them into your daily routine, you can better cope with joint pain associated with the virus connection between rheumatoid arthritis and the Epstein-Barr virus. Remember to work closely with your healthcare team to develop a comprehensive treatment plan tailored to your specific needs.
Lifestyle Factors and Prevention
When it comes to preventing the development or progression of autoimmune diseases like rheumatoid arthritis, lifestyle factors play a crucial role. Adopting healthy habits can help support the immune system and reduce the risk of autoimmune diseases. Here are some key lifestyle factors and strategies to consider:
1. Regular Exercise
Engaging in regular physical activity can have numerous benefits for overall health, including the prevention of autoimmune diseases. Exercise helps strengthen the immune system, reduces inflammation, and promotes joint health. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Incorporate a combination of cardiovascular exercises, strength training, and flexibility exercises into your routine.
2. Balanced Diet
Adopting a balanced and nutritious diet is essential for supporting the immune system and preventing autoimmune diseases. Include a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats in your meals. Focus on incorporating foods rich in antioxidants, omega-3 fatty acids, and vitamin D, as they have been associated with reduced inflammation and improved immune function.
3. Stress Management
Chronic stress can weaken the immune system and increase the risk of autoimmune diseases. Practice stress management techniques such as meditation, deep breathing exercises, yoga, or engaging in hobbies you enjoy. Prioritize self-care and carve out time each day for relaxation and rejuvenation.
4. Adequate Sleep
Getting enough quality sleep is crucial for maintaining a healthy immune system. Aim for 7-9 hours of sleep each night and establish a relaxing bedtime routine. Create a sleep-friendly environment, limit screen time before bed, and avoid consuming stimulating substances like caffeine close to bedtime.
5. Avoid Tobacco and Excessive Alcohol Consumption
Tobacco use and excessive alcohol consumption have been linked to an increased risk of autoimmune diseases. Quitting smoking and limiting alcohol intake can significantly improve overall health and reduce the risk of developing these conditions.
6. Regular Check-ups and Screenings
Regular check-ups and screenings can help detect and manage autoimmune diseases at an early stage. Consult with your healthcare provider regularly and discuss any concerns or symptoms you may have. Follow their recommendations for routine vaccinations and screenings.
By incorporating these lifestyle factors into your daily routine, you can take proactive steps towards preventing autoimmune diseases like rheumatoid arthritis. Remember that every individual is unique, so it’s essential to consult with healthcare professionals for personalized advice and guidance.
Future Research and Insights
As our understanding of rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV) link continues to evolve, there are several potential areas for future research that hold promise for enhancing our knowledge of this correlation and its impact on chronic inflammatory diseases.
1. Mechanisms of EBV and Rheumatoid Arthritis
Further investigation is needed to delve deeper into the mechanisms by which the Epstein-Barr virus may contribute to the development and progression of rheumatoid arthritis. Understanding the specific interactions between EBV and the immune system, as well as their potential influence on joint inflammation, could lead to breakthroughs in treatment and prevention strategies.
2. Genetic Factors and Susceptibility
Research exploring genetic factors involved in the susceptibility to both rheumatoid arthritis and EBV infection could shed light on the underlying mechanisms of this correlation. Investigating specific genes and their influence on the immune response to EBV and subsequent development of RA may help in identifying individuals at higher risk and developing personalized therapies.
3. Long-term Impact and Prognosis
Further studies are needed to examine the long-term impact of co-occurring rheumatoid arthritis and EBV infection on individuals’ overall health and quality of life. Understanding the progression of the diseases, the impact on joint health, and the effectiveness of different treatment strategies can aid in improving prognosis and developing targeted interventions.
4. Immunomodulatory Therapies
Investigating the potential of immunomodulatory therapies, such as antiviral medications or vaccines, in treating rheumatoid arthritis associated with the Epstein-Barr virus could open up new avenues for therapeutic interventions. Clinical trials and research studies focusing on these treatment approaches hold promise for managing joint inflammation and improving outcomes.
5. Early Detection and Prevention Strategies
Developing reliable methods for early detection and risk assessment of rheumatoid arthritis in individuals with EBV infection could enable timely interventions and preventive measures. Exploring biomarkers, imaging techniques, and predictive models may help identify individuals at higher risk and initiate interventions that could halt or slow down disease progression.
By exploring these future research areas, we can uncover valuable insights into the complex relationship between rheumatoid arthritis and the Epstein-Barr virus, ultimately leading to improved diagnostic tools, more targeted treatments, and enhanced management strategies for chronic inflammatory diseases.
The Impact of Co-occurring RA and EBV
Co-occurring rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV) can have a significant impact on individuals’ overall health and quality of life. The presence of both conditions can complicate treatment approaches and prognosis. Understanding the implications of this dual diagnosis is crucial for healthcare providers and patients alike.
Influence on Treatment Approaches
Rheumatoid Arthritis & Epstein-Barr Virus Link When a person is diagnosed with both RA and EBV, healthcare providers must consider various factors when determining treatment approaches. The presence of EBV may exacerbate symptoms of rheumatoid arthritis, leading to increased joint inflammation and pain. In such cases, treatment plans might need to be adjusted to manage both conditions effectively.
The treatment approach for co-occurring RA and EBV often involves a combination of medications to manage joint inflammation, control viral activity, and boost the immune response. This integrated approach aims to alleviate symptoms, slow disease progression, and improve overall well-being.
Prognostic Implications
Rheumatoid Arthritis & Epstein-Barr Virus Link The co-occurrence of RA and EBV can also have prognostic implications. Research suggests that individuals with both conditions may experience more severe joint damage and a higher likelihood of disease progression compared to those with RA alone. The interplay between the immune system dysregulation caused by EBV and the chronic inflammation characteristic of RA can contribute to this heightened risk.
However, it is important to note that each individual’s prognosis depends on various factors, including the severity of RA symptoms, viral activity, overall health, and treatment adherence. Close monitoring by healthcare professionals is crucial to assess disease progression and adjust treatment plans accordingly.
Continued Research and Collaborations
Organizations like the Acibadem Healthcare Group are at the forefront of research and collaborations focused on understanding the impact of co-occurring rheumatoid arthritis and the Epstein-Barr virus. Through ongoing studies and clinical trials, these initiatives aim to shed light on the underlying mechanisms of this connection and advance treatment strategies.
By fostering interdisciplinary collaborations and sharing insights across the medical community, healthcare providers can stay updated on the latest research findings and provide the best possible care to individuals with both RA and EBV.
Conclusion
Rheumatoid Arthritis & Epstein-Barr Virus Link In conclusion, the potential connection between rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV) is a topic that warrants further exploration. The latest research suggests that viral infections, particularly EBV, may play a role in the development and exacerbation of RA. This correlation highlights the complex interplay between the immune system, chronic inflammatory diseases, and infectious agents like EBV.
It is crucial to recognize the impact of autoimmune diseases, such as RA, and their link to viral infections. Ongoing research, including studies conducted by organizations like the Acibadem Healthcare Group, helps to shed light on this connection and deepen our understanding of the underlying mechanisms.
Furthermore, understanding the immune system responses to the Epstein-Barr virus can provide valuable insights into the development of chronic inflammatory diseases like RA. This knowledge opens doors to potential treatment options that target the immune response and alleviate joint pain associated with these conditions.
In conclusion, this article has highlighted the correlation between rheumatoid arthritis and the Epstein-Barr virus. We have explored the immune system’s response to EBV, the impact of viral infections on arthritis, and treatment options for individuals with both conditions. Ongoing research in this field is crucial for advancing our understanding and improving the lives of those affected by autoimmune diseases. Rheumatoid Arthritis & Epstein-Barr Virus Link
FAQ
Is there a link between rheumatoid arthritis and the Epstein-Barr virus?
While research is ongoing, several studies suggest a potential connection between rheumatoid arthritis (RA) and the Epstein-Barr virus (EBV). The exact nature of this link and its underlying mechanisms are still being explored.
What is rheumatoid arthritis?
Rheumatoid arthritis is a chronic inflammatory joint condition. It causes pain, swelling, stiffness, and decreased mobility in the joints. RA is an autoimmune disease, meaning that the immune system mistakenly attacks the body's own healthy tissues, specifically the joints.
What is the Epstein-Barr virus?
The Epstein-Barr virus is a common human herpesvirus. It is primarily transmitted through saliva and can cause infectious mononucleosis (commonly known as mono or glandular fever). EBV can establish a lifelong latent infection in the body, with occasional reactivations, but most people do not show symptoms.
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