Molecular Characterization of Epstein-Barr virus Based on EBNA3C Protein among Hematopoietic Stem Cell Transplant Recipients in Jordan

Background: Epstein-Barr virus (EBV), a human herpes virus, presents significant risks to hematopoietic stem cell transplant (HSCT) recipients due to immunosuppressive treatments. Two genotypes of EBV can infect humans: EBV1 and EBV2. These genotypes differ in their latent genes. One important latent protein is EBNA3, which plays a crucial role in immune evasion and pathogenesis of EBV. Objectives: This study characterizes EBV genotypes among HSCT recipients in Jordan and examines the relationship between EBV positivity and demographic factors. Methods: A retrospective observational study was conducted at the Jordanian Royal Medical Services Hospital (JRMS) from January to October 2024. Blood samples were collected from the virology department, and plasma was separated. EBV-DNA detection was performed using quantitative real-time PCR, while conventional PCR targeted EBNA3C genes for genotyping. Results: Out of 93 EBV-positive HSCT recipients, 31 underwent genotyping analysis. The findings revealed a predominance of EBV2, detected in 26 samples (84%), while 5 samples (16%) exhibited mixed infections. Notably, EBV1 was not identified in any samples. A significant association was found between EBV positivity and male recipients, with a markedly higher prevalence in individuals under 18 years of age (P<0.0001). Conclusion: EBV2 was the predominant genotype among HSCT recipients in Jordan, with co-infections of EBV1 and EBV2. Understanding the prevalent genotypes in transplant patients is crucial for managing EBV-related complications, ultimately improving patient outcomes. This study highlights the need for continuous monitoring and characterization of EBV genotypes in immunocompromised populations.