GENE EBNA3C: TYPES OF INFECTION BY EBV (EBV1 and EBV2), CORRELATION WITH CLINICAL AND BIOCHEMICAL PARAMETERS (AST, ALT and GGT) IN INDIVIDUALS WITH INFECTIOUS MONONUCLEOSIS OF THE METROPOLITAN AREA OF BELÉM, PARÁ, IN THE PERIOD OF 2005-2016

Two types of EBV (EBV1 and 2) have been shown to infect humans. Detect the types of EBV that cause infectious mononucleosis and correlate these viral types with biochemical parameters (AST, ALT and GGT) on in the metropolitan region of Belém, 2005 to 2016. A total 76 cases of infectious mononucleosis, processed the Instituto Brazil. Evaluated by PCR used primers the region EBNA 3C. EBV1 infection was observed in 71.1% (54/76) of individuals, among whom those > 14 years constituted 66.7% (36/54), the average age was 23 years, and the number of women infected was higher (61.1% 33/54) than that of men (38.9%21/54). The symptoms/clinical signs observed in infection by EBV1 were cervical lymphadenopathy in 64.8% (35/54), fever in 63% (34/54), headache and arthralgia in 20.3% (11/54), and exanthema in 18.5% (10/54). Infection by EBV2 was observed in only 17.1% (13/76) of cases. Co-infection by EBV1 and EBV2, most frequently showing symptoms of fever and cervical lymphadenopathy, occurred in 66.7 (6/9) and 55.6% (5/9) of individuals. EBV1 was predominant in 71% of clinical cases of infectious mononucleosis. Correlation of biochemical parameters in infection by EBV1, EBV2, and co-infection by EBV1/2 revealed a statistically significant difference in mean changes of EBV1 in individuals older than 14 years. descriptive and retrospective. Samples from 76 clinical cases of infectious mononucleosis that were reactive to tested by enzyme immunoassay kit, processed in and biochemical in evaluated by PCR for the gene for of revealed a statistically significant difference in mean changes of EBV1 in individuals older than 14 years.

infectious mononucleosis (IgMVCA / EBV +) and to relate biochemical parameters (ASL, ALT and GGT) from the metropolitan area of Belém between 2005 and 2016.

Type of Study
The current study was descriptive and retrospective. Samples from 76 clinical cases of infectious mononucleosis that were reactive to EBV/VCA IgM, tested by the RIDASCREEN® (R-Biopharm,

Identification of the EBV EBNA3C gene
For the identification of EBV type we used EBNA-3C primer 17. Due to the flanking regions of the typespecific variation primary sites, the resulting PCR products were of two different sizes derived from EBV1 (153pb) and EBV2 (246pb). Five microliters of the eluted ADN were used for PCR amplification with a primer concentration of 0.05 μM (5' GCCAGAGGTAAGTGGACTTT 3' and 5' TGGAGAGGTCAGGTTACTTA 3', respectively). PCR was performed in 0. 5  As to the clinical picture, a multiplicity of signs and symptoms were noticed, such as: fever in 65.8% The EBV1 infection was observed in 71.1% (54/76); the most frequent age group was> 14 years old, with 66.7% (36/54) of the individuals, since the age range was of 23 years, the number of women was higher 61.1% (33/54) was higher than in men with 38.9% (21/54).
In the assessment of hepatic function, alterations to AST in EBV1 infection were confirmed in 14,8% (8/54) with results above the reference values (5-40 U/L) and 7.7% (1/13) for EBV2. It is worth mentioning that the reference values are the same in the three age groups (Fig 2). When analyzing the mean values by age group, the range of >14 years was outside the normality limits with more frequency of alterations, thus presenting statistical difference (p-value < 0.05).
Values above the reference values (2-41 U/L) were also observed for ALT (Fig 3). The mean value was outside the limits of normality in the age groups of 6 to 14 years and >14 years, presenting a statistical difference (p-value < 0.05) by the Wilcoxon test.
For the evaluation of GGT, some altered results were observed, but no changes were found in the age group of 2 to 5 years, given the reference values: (5 -55 U/L), changes in the age group from 6 to 14 years were all values above normal, given the same reference range of the previous age group, and in the range of >14 years the greatest number of alterations were perceived, above or below, given reference values: (12 -43 U/L) (Fig 4).The mean value was outside the limits of normality in the age group of > 14 years, and the mean values presented a statistical difference (p-value <0.05) by the Wilcoxon test.

Discussion
Primary EBV infection is usually asymptomatic and may progress to benign lymphoproliferative disease called infectious mononucleosis (IM), especially in late childhood or early adulthood in developing countries 4.     Evaluation of GGT activity in individuals with EBV 1, EBV 2 and EBV 1 and 2 infection.