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Infectious Mononucleosis &
Epstein-Barr Virus (EBV) |
Epstein-Barr Virus (EBV) is one of the most
commonly contracted herpesviral infections. The infection usually occurs
early in life (before age 5) but is generally asymptomatic. By the age
of 40, 95% of the US population has been exposed to EBV. However, when
EBV infection occurs during adolescence or young adulthood, it causes
infectious mononucleosis 35% to 50% of the time. The main population
affected by mononucleosis is young adults between 19 and 24 years of
age, making this disease a significant problem for college campuses and
for the military.
Infectious mononucleosis commonly triggers a protracted, post-infective
fatigue syndrome. Symptoms of mononucleosis can include sore throat, fever,
and swollen lymph glands. In rare situations, infection can lead to more
serious issues such as heart or central nervous system problems.
Acute infectious mononucleosis may be associated with a relatively long period
of asthenia in which the body lacks or has lost strength either as a
whole or in any of its parts. Fatigue was the most prominent residual
complaint in a study that followed 140 young adults in their early
twenties with primary EBV infectious mononucleosis for 6 months. Fatigue
was reported in 28% of subjects one month after onset of illness. The
fatugue was still present 2 and 6 months later in 21% and 13% of the
subjects, respectively. Headache was a problem for 50% of the patients
during the acute illness and persisted for at least 6 months in 15% of
the patients.
Even when symptoms of an active infection resolve, EBV remains dormant
or latent in cells in the throat and blood for the rest of a person's life. From time to time, the virus can reactivate and an infected person will be able to transmit the virus
through saliva again. EBV has also been associated with an increased
risk of developing multiple sclerosis. Additionally EBV is a
significant problem in solid organ and stem cell transplants causing
Post Transplant Lymphoproliferative Disorder (PTLD).
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Valomaciclovir (EPB-348) and "Mono"
For acute infectious mononucleosis, treatment is currently
limited to mitigating the symptoms rather than addressing the viral
infection directly. There is no approved antiviral therapy or vaccine
for the treatment or prevention of mononucleosis. Valomaciclovir has
demonstrated excellent in vitro anti-viral activity against EBV.
A Phase 2 study of Valomaciclovir and infectious mononucleosis has
been successfully completed. There is a clear unmet need for an
effective antiviral such as Valomaciclovir to treat patients suffering
from mononucleosis. |
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