Antibody to Epstein-Barr virus in man in Australia and New Guinea

IgA Nephropathy: Pleiotropic impact of Epstein-Barr virus infection on immunopathogenesis and racial incidence of the disease

IgA nephropathy (IgAN) is an autoimmune disease in which poorly galactosylated IgA1 is the antigen recognized by naturally occurring anti-glycan antibodies, leading to formation of nephritogenic circulating immune complexes. Incidence of IgAN displays geographical and racial disparity: common in Europe, North America, Australia, and east Asia, uncommon in African Americans, many Asian and South American countries, Australian Aborigines, and rare in central Africa. In analyses of sera and cells from White IgAN patients, healthy controls, and African Americans, IgAN patients exhibited substantial enrichment for IgA-expressing B cells infected with Epstein-Barr virus (EBV), leading to enhanced production of poorly galactosylated IgA1. Disparities in incidence of IgAN may reflect a previously disregarded difference in the maturation of the IgA system as related to the timing of EBV infection. Compared with populations with higher incidences of IgAN, African Americans, African Blacks, and Australian Aborigines are more frequently infected with EBV during the first 1-2 years of life at the time of naturally occurring IgA deficiency when IgA cells are less numerous than in late childhood or adolescence. Therefore, in very young children EBV enters "non-IgA" cells. Ensuing immune responses prevent infection of IgA B cells during later exposure to EBV at older ages. Our data implicate EBV-infected cells as the source of poorly galactosylated IgA1 in circulating immune complexes and glomerular deposits in patients with IgAN. Thus, temporal differences in EBV primo-infection as related to naturally delayed maturation of the IgA system may contribute to geographic and racial variations in incidence of IgAN.

Seroepidemiological study of infectious mononucleosis in older patients

In southern Tasmania, Australia, primary Epstein-Barr virus infection occurs in adults greater than 30 years of age at a higher frequency (approximately 13% of all cases) than is generally reported for other parts of the world, and approximately 7% of the general population of the region have no antibodies to the virus. Epstein-Barr virus should not be overlooked as a possible cause of disease in older patients in similar populations elsewhere.

Growth and immune function in Aboriginal children during recovery from malnutrition and infection

The clinical, nutritional progress and immunological changes of 30 Aboriginal children admitted to the Alice Springs Hospital with malnutrition and infection, and 11 adequately nourished children admitted with acute infection were studied. The initial toxic phase of infection lasted from six to 21 days during which the mean weight velocity of malnourished children averaged 8-8 g/kg/day. The subsequent period of nutritional rehabilitation was accompanied by a slower weight velocity of 3-7 g/kg/day up to a body weight at discharge of approximately 80% standard weight for age. The principal clinical form of malnutrition was moderate protein calorie malnutrition of marasmic type. All children showed laboratory evidence of persistent immunological stimulation with leukocytosis, elevated numbers of T and B lymphoid cells, raised erythrocyte sedimentation rates and hyperimmunoglobulinaemia. These findings were not significantly changed by short-term antibiotic therapy and nutritional rehabilitation and may indicate an underlying defect resulting in the high rate of reinfection and readmission of these children.