Epstein-Barr Virus and Pediatric Sepsis: Unraveling Links to Immune Dysregulation and Mortality

Introduction and Background

Epstein-Barr Virus (EBV), a ubiquitous herpesvirus infecting a majority of the global population during childhood or adolescence, has long been associated with various chronic immune-related conditions, such as multiple sclerosis, systemic lupus erythematosus, and certain cancers. Its role in immune modulation is complex, involving establishing latent infection within B cells and influencing immune system behavior over time. Meanwhile, sepsis remains a major global health challenge, accounting for nearly 10% of all deaths worldwide, with children being particularly vulnerable due to their developing immune systems.

Historically, sepsis has been viewed as an acute dysregulated immune response to infection. Despite advancements in supportive care, morbidity and mortality rates remain high, emphasizing the need to better understand underlying immune mechanisms. Emerging evidence suggests that prior immune modulations, such as persistent in vivo infections like EBV, may influence the trajectory and outcomes of acute illnesses like sepsis.