EPSTEIN-BARR-VIRUS REPLICATION IN HODGKINS-DISEASE

Epstein-Barr virus (EBV) is present in up to 40% of Hodgkin's disease (HD). The viral genomes remain latent within Reed-Sternberg cells (RS cells), but the recent detection of Zebra protein in rare neoplastic cells of a few EBV+ HD cases, suggests an activation of EBV replication. We have studied fifty HD cases containing EBV genomes and expressing LMP1 protein (including five AIDS-related cases), by immunohistochemistry with anti-Zebra antibodies. Four of these cases (all HIV-) showed Zebra+ tumor cells. One of these four cases showed numerous Zebra+ neoplastic cells (approximately 1 % of tumor cells) and positive staining for EA-R protein, thus indicating early gene expression. In situ hybridization with biotinylated BamHI W probe revealed in this case, a signal of unusual strength within some Reed-Sternberg cells, probably related to increased number of EBV genomes, thus suggesting EBV replication. Viral replication was finally confirmed in this case, by the detection of BLLF1 transcripts (encoding for the membrane antigen gp 3501220) using reverse transcriptase and polymerase chain reaction. Thus, a very few Zebra+ neoplastic cells are concerned by viral replication, most of them harboring EBV involved in an abortive, instead of a full lytic cycle. EBV replication in RS cells remains an exceptionnal event, but may provide clues to immunologic mechanisms of control of viral latency. Clinical implications need further investigations.