UMMS Affiliation

Department of Quantitative Health Sciences; Department of Pediatrics

Publication Date


Document Type



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.

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Copyright: © 2012 Snider et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI of Published Version



PLoS One. 2012;7(3):e31753. Epub 2012 Mar 12. Link to article on publisher's site

Journal/Book/Conference Title

PloS one

PubMed ID


Related Resources

Link to Article in PubMed