{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:11:27Z","timestamp":1782925887646,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Epstein\u2013Barr virus (EBV) is a globally prevalent herpesvirus associated with multiple diseases. This study aimed to determine the characteristics of primary EBV infection disease spectrum and reactivation in children, in Suzhou, China. All children admitted to the Children's Hospital of Soochow University between May 2018 and September 2020 with suspected EBV\u2010associated disease and subjected to the indirect immunofluorescence assay for EBV\u2010specific antibodies and plasma EBV\u2010DNA assays were included. Of the 3567 children, 2782 (78.0%) tested positive for EBV. The positive rates of viral capsid antigen (VCA)\u2010IgM, VCA\u2010IgG, early antigen (EA)\u2010IgG, nuclear antigen (EBNA)\u2010IgG, and plasma EBV\u2010DNA were 12.1%, 74.6%, 37.9%, 35.6%, and 31.1%, respectively. The lowest VCA\u2010IgG and EBNA\u2010IgG seropositivity rates occurred at ages between 8 and 36 months, then increased gradually in the older age groups. The EBV\u2010IgM seropositivity rate was the highest in those aged 36 to &lt;72 months. Primary EBV infection was more common in children aged 36 to &lt;72 months. In past infections, reactivation mainly occurred in 8 to &lt;36 months. The most common disease caused by primary EBV infection was infectious mononucleosis (56.1%), followed by a respiratory infection (17.0%). Respiratory infection (30.0%), EBV infection (29.2%), and hemophagocytic lymphohistiocytosis (HLH) (15.8%) were the commonest diseases caused by EBV reactivation. EBV reactivation was a risk factor for HLH (adjusted odds ratio, 16.4; 95% confidence interval, 7.9\u201334.0). Among reactivated patients, the viral load of HLH was higher than that of EBV infection and respiratory infection (<jats:italic>p\u2009<\/jats:italic>&lt;\u2009.01). This is a retrospective large sample study that explored the characteristics of primary EBV infection disease spectrum and reactivation in children.<\/jats:p>","DOI":"10.1002\/jmv.26941","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T06:55:17Z","timestamp":1615791317000},"page":"5048-5057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Characteristics of primary Epstein\u2013Barr virus infection disease spectrum and its reactivation in children, in Suzhou, China"],"prefix":"10.1002","volume":"93","author":[{"given":"Ting","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Huang","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengrong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0729-7196","authenticated-orcid":false,"given":"Jianmei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Children's Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"issue":"43","key":"e_1_2_9_2_1","first-page":"216","article-title":"Epidemiology of the Epstein\u2010Barr virus infection and associated tumors in man","author":"De Th\u00e9 G","year":"1975","journal-title":"Bibl Haematol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-0670-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064921"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit096"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc1452"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(02)00119-1"},{"issue":"2","key":"e_1_2_9_8_1","article-title":"Infectious mononucleosis (Epstein\u2010Barr virus infection) and chronic hepatitis","volume":"16","author":"\u010calki\u0107 L","year":"2019","journal-title":"Med Glas (Zenica)"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/CDLI.7.3.451-456.2000"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.DMIH2-0011-2015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2018.38.5.458"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0010.6287"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25633"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.10439"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099857"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193171"},{"issue":"3","key":"e_1_2_9_17_1","first-page":"183","article-title":"Analysis of Epstein Barr virus infection in 761 hospitalized children","volume":"15","author":"Chen Q","year":"2013","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-1702(01)00436-1"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/biores.2012.0274"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1309\/ETK2-L9MG-L6RA-N79Y"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-011-1561-z"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00211"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens9030226"},{"issue":"1","key":"e_1_2_9_24_1","first-page":"211","article-title":"Infectious mononucleosis","volume":"390","author":"Dunmire SK","year":"2015","journal-title":"Curr Top Microbiol Immunol"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2018.03.001"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/jinf.2002.1022"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-10-55"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1100\/tsw.2011.62"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00445-07"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.26941","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.26941","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.26941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T07:25:19Z","timestamp":1692602719000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.26941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,25]]},"references-count":28,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1002\/jmv.26941"],"URL":"https:\/\/doi.org\/10.1002\/jmv.26941","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,25]]},"assertion":[{"value":"2020-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}