Epstein-Barr Virus: paving the way for a vaccine using epidemiological and mathematical modelling approaches

Epstein Barr virus (EBV), a lymphocryptovirus, permanently infects more than 90% of humans. EBV causes more than 90% of cases of glandular fever and is linked to 1% of global cancers. Why only a small fraction of infected people get cancer is poorly understood. No anti-EBV vaccines are currently licensed, although several candidates are in pre-clinical development. Lymphocryptoviruses have evolved with humans for many millennia. Our immune systems are likely to be well adapted to EBV and vice versa. The impact of EBV infection through the human life course is not known, nor is that of remaining permanently EBV-negative. As vaccines become available such questions will become increasingly important. Information derived from large cohorts and mathematical models of transmission will be critical before vaccines can be adopted. Before extensive investment in a vaccine for EBV, a feasibility and scoping exercise of currently available data and resources is required.

We will use pre-existing datasets, pilot assembly of a cohort of EBV-seronegative people for a life-course study and undertake systematic reviews to determine the strength of available evidence for different risk factors for EBV infection and EBV-associated cancers in different settings. We will also develop a preliminary transmission dynamic model for vaccination and identify knowledge gaps for a full model.

Our research can be used to inform the development of a vaccine for EBV.