Department of Quantitative Health Sciences; Department of Pediatrics
Medical Subject Headings
Adolescent; Burkitt Lymphoma; CD8-Positive T-Lymphocytes; Child; Child, Preschool; Coinfection; Enzyme-Linked Immunospot Assay; Herpesvirus 4, Human; Humans; Immunity, Cellular; Infant; Interferon-gamma; Kenya; Malaria, Falciparum; Prevalence; Recurrence
Epidemiology | Health Services Research | Immunology and Infectious Disease | Parasitic Diseases | Virus Diseases
Plasmodium falciparum malaria (Pf-malaria) and Epstein Barr Virus (EBV) infections coexist in children at risk for endemic Burkitt's lymphoma (eBL); yet studies have only glimpsed the cumulative effect of Pf-malaria on EBV-specific immunity. Using pooled EBV lytic and latent CD8+ T-cell epitope-peptides, IFN-gamma ELISPOT responses were surveyed three times among children (10 months to 15 years) in Kenya from 2002-2004. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated in association with Pf-malaria exposure, defined at the district-level (Kisumu: holoendemic; Nandi: hypoendemic) and the individual-level. We observed a 46% decrease in positive EBV lytic antigen IFN-gamma responses among 5-9 year olds residing in Kisumu compared to Nandi (PR: 0.54; 95% CI: 0.30-0.99). Individual-level analysis in Kisumu revealed further impairment of EBV lytic antigen responses among 5-9 year olds consistently infected with Pf-malaria compared to those never infected. There were no observed district- or individual-level differences between Pf-malaria exposure and EBV latent antigen IFN-gamma response. The gradual decrease of EBV lytic antigen but not latent antigen IFN-gamma responses after primary infection suggests a specific loss in immunological control over the lytic cycle in children residing in malaria holoendemic areas, further refining our understanding of eBL etiology.