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Epstein-Barr virus
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==Treatment== There is no specific treatment for EBV, only treatment of symptoms, such as taking over-the-counter medications for pain and fever.<ref name="CDC" /> EBV is thought to persistent harmlessly in immunocompetent individuals, but in those with compromised immune systems it has been associated with certain cancers and possibly autoimmune disease. ===Antivirals=== Several [[antiviral]]s are active against EBV including [[valganciclovir]], [[valacyclovir]]<ref name="Hoshino2009">{{Cite journal | title = Long-term administration of valacyclovir reduces the number of Epstein-Barr virus (EBV)-infected B cells but not the number of EBV DNA copies per B cell in healthy volunteers | date = Nov 2009| url = https://pubmed.ncbi.nlm.nih.gov/19740997/|journal=Journal of Virology|volume=83|issue=22 | pages = 11857β11861 | last = Hoshino | first = Yo | author-link = | last2 = Katano | first2 = Harutaka | authorlink2 = | last3 = Zou | first3 = Ping | authorlink3 = | last4 = Hohman | first4 = Patricia | authorlink4 = | last5 = Marques | first5 = Adriana | authorlink5 = | last6 = Tyring | first6 = Stephen K. | author-link6 = | last7 = Follmann | first7 = Dean | last8 = Cohen | first8 = Jeffrey I.|doi=10.1128/JVI.01005-09|pmc=2772668|pmid=19740997|access-date=|issn=1098-5514|quote=|via=}}</ref>, [[acyclovir]]<ref name="Rafaillidis2013">{{Cite journal | title = Antiviral treatment for severe EBV infections in apparently immunocompetent patients | date = Nov 2010| url = https://pubmed.ncbi.nlm.nih.gov/20739216/|journal=Journal of Clinical Virology: The Official Publication of the Pan American Society for Clinical Virology|volume=49|issue=3 | pages = 151β157 | last = Rafailidis | first = Petros I. | authorlink = | last2 = Mavros | first2 = Michael N. | authorlink2 = | last3 = Kapaskelis | first3 = Anastasios | authorlink3 = | last4 = Falagas | first4 = Matthew E. | author-link4 = |doi=10.1016/j.jcv.2010.07.008|pmc=|pmid=20739216|access-date=|issn=1873-5967|quote=|via=}}</ref>, and [[spironolactone]].<ref name="Verma2016">{{Cite journal | last1 = Verma | first1 = Dinesh | last2 = Thompson | first2 = Jacob | last3 = Swaminathan | first3 = Sankar| title = Spironolactone blocks EpsteinβBarr virus production by inhibiting EBV SM protein function | journal =Proceedings of the National Academy of Sciences | issn = 1091-6490 | volume = 113 | issue = 13| pages = 3609β3614 | date = 2016-03-29 | doi = 10.1073/pnas.1523686113 | pmid = 26976570| url = http://www.pnas.org/content/113/13/3609}}</ref> [[Acyclovir]], an [[antiviral]] drug which inhibits (but does not destroy) herpesviruses, was shown to also inhibit the virus production. This suggests that EBV replicates via lytic replication. A theoretical [[immunotherapy]] treatment proposes that inducing [[CD1d]] expression on EBV-infected B cells could prompt effective immune suppression of EBV by natural killer T cells.<ref name="Priatel2014"/> ===Rituximab=== [[Rituximab]] may be effective in completely eliminating EBV infection from the peripheral blood.<ref>{{Cite journal | last = Diamantopoulos | first = Panagiotis T. | last2 = Polonyfi | first2 = Katerina | last3 = Sofotasiou | first3 = Maria | last4 = Papadopoulou | first4 = Vasiliki | last5 = Kalala | first5 = Fani | last6 = Iliakis | first6 = Theodoros | last7 = Zervakis | first7 = Kostantinos | last8 = Tsilimidos | first8 = Gerassimos | last9 = Kouzis | first9 = Panagiotis | date = Dec 2013 | title = Rituximab in the treatment of EBV-positive low grade B-cell lymphoma| url = https://www.ncbi.nlm.nih.gov/pubmed/24324119|journal=Anticancer Research|volume=33|issue=12 | pages = 5693β5698|issn=1791-7530|pmid=24324119}}</ref> A study of seventeen patients with low-grade [[B cell]] lymphoma found that after three cycles of rituximab, the virus had been completely eliminated from the peripheral blood in all but one patient. ===Herbs and nutraceuticals=== Though not tested in clinical trials, licorice derivatives quercetin and isoliquiritigenin inhibit EBV in cell cultures.<ref>{{Cite journal | title = Quercetin-induced apoptosis prevents EBV infection | date = 2015-05-20| url = https://pubmed.ncbi.nlm.nih.gov/26059439|journal=Oncotarget|volume=6|issue=14 | pages = 12603β12624 | last = Lee | first = Minjung | last2 = Son | first2 = Myoungki | last3 = Ryu | first3 = Eunhyun | last4 = Shin | first4 = Yu Su | last5 = Kim | first5 = Jong Gwang | last6 = Kang | first6 = Byung Woog | last7 = Cho | first7 = Hyosun | last8 = Kang | first8 = Hyojeung|doi=10.18632/oncotarget.3687|pmc=4494961|pmid=26059439|issn=1949-2553}}</ref> [[Vitamin C]]<ref name="Mikirova2014">{{Cite journal | title = Effect of high dose vitamin C on Epstein-Barr viral infection | date = 2014-05-03| url = https://pubmed.ncbi.nlm.nih.gov/24793092/|journal=Medical Science Monitor: International Medical Journal of Experimental and Clinical Research|volume=20 | pages = 725β732 | last = Mikirova | first = Nina | last2 = Hunninghake | first2 = Ronald|doi=10.12659/MSM.890423|pmc=4015650|pmid=24793092|issn=1643-3750}}</ref> and Vitamin D<sub>3</sub><ref name="Rolf2017">{{Cite journal | title = Exploring the effect of vitamin D3 supplementation on the anti-EBV antibody response in relapsing-remitting multiple sclerosis | date = Sep 2018| url = https://pubmed.ncbi.nlm.nih.gov/28731372/|journal=Multiple Sclerosis (Houndmills, Basingstoke, England)|volume=24|issue=10 | pages = 1280β1287 | last = Rolf | first = Linda | author-link = | last2 = Muris | first2 = Anne-Hilde | authorlink2 = | last3 = Mathias | first3 = Amandine | authorlink3 = | last4 = Du Pasquier | first4 = Renaud | authorlink4 = | last5 = Koneczny | first5 = Inga | authorlink5 = | last6 = Disanto | first6 = Giulio | authorlink6 = | last7 = Kuhle | first7 = Jens | last8 = Ramagopalan | first8 = Sreeram | last9 = Damoiseaux | first9 = Jan | last10 = Smolders | first10 = Joost | last11 = Hupperts | first11 = Raymond|doi=10.1177/1352458517722646|pmc=6108041|pmid=28731372|access-date=|issn=1477-0970|quote=|via=}}</ref> might also decrease duration and severity of the symptoms of EBV infection. ===Vaccine=== A [[vaccine]] for the prevention of Epstein-Barr virus is being explored.<ref name="Vaccine2019">{{Cite web | url=https://www.nih.gov/news-events/news-releases/nih-researchers-make-progress-toward-epstein-barr-virus-vaccine | title = NIH researchers make progress toward Epstein-Barr virus vaccine | date = 2019-04-09 | website = National Institutes of Health (NIH)|language=en|access-date=2019-04-10}}</ref>
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