The Role of Epstein-Barr Virus in Adenoid and Tonsil Enlargement in Nigerian Children.

Abstract

Background: Epstein-Barr Virus (EBV) is a lymphotropic virus that persists in lymphoid tissues such as the adenoids and tonsils and has been associated with several head and neck diseases. Because adenotonsillar enlargement is common in children, this study investigated whether EBV contributes to hypertrophy of these tissues. Methodology: A comparative cross-sectional study was conducted at the University of Abuja Teaching Hospital involving 90 age and sex-matched children, 45 test and 45 control. Adenoid size was assessed radiologically using the Fujioka Adenoid-Nasopharyngeal Ratio (ANR), tonsil size was graded with the Brodsky system, and EBV status was determined using Chemiluminescence Immunoassay. Postoperative tissue volumes were also measured. Results: Ninety children (test: 45; control: 45) participated; groups were age- and sex-matched (p = 0.480). Mean ages were 51.7±5.4 months (test) and 66.5±5.6 months (control). Mean Brodsky grade was 2.80±0.99, and mean ANR was 0.72±0.21.EBV IgG prevalence for the test group was 91.1% and 8.9% were EBV negative prevalence, and 82% with 17% for control respectively. There was also a significant difference between the mean values of the EBV IgG titers in the test and control groups using the T-test analysis. T= 12.956, p= <0.001. The Odds ratio was 2.6. Only two (2) patients in the test group tested positive for EBV IgM and IgG. There was a positive correlation between EBV status and tonsil volume p=0.0320, r =0.320 and Brodsky grade r= 0.338 p= 0.023. However, the adenoid volume and ANR showed a weaker correlation with the EBV status of the test patients p= 0.466, r= 0.113. Conclusion: hypertrophy, and to a lesser extent adenoidal enlargement.