【摘要】EB病毒再激活是异基因造血干细鉋移植(allo-HSCT)术后常见的并发症，病死率达13.8%，allo-HSCT后机体的免疫抑制状态和慢性炎症反应可促进EB病毒的复制。近年来，端粒特异性逆转录酶(TERT)调控EB病毐发生裂解感染的机制得到进一步阐明。allo-HSCT后EB病毒再激活与多种因素相关，其治疗仍较困难。抢先治疗可以有效降低EB病毒感染相关死亡率，但该治疗方法的干预时机仍未完全明确，利妥昔单抗及早期减停免疫抑制拥广泛应用于allo-HSCT后EB病毒拜激活的临床治疗，而目前该病免疫疗法的研究也取得较大进展。笔者拟就allo-HSCT术后EB病毒再激活的感染机制、影响因素、诊断及治疗进行综述。

【关键词】Epstein-Barr病毒感染；造血干细胞移植；免疫抑制剂；免疫疗法

基金项目：国家自然科学基金面上项目(81570105)

【Abstract】 EB virus reactivation is one of the common complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) ，with the fatality rate as 13.8%. Immune depression and chronic inflammation play key roles in EB virus replication. Besides， the mechanism of EB virus lytic replication modulated by telomere specific reverse transcriptase (TERT) have been explained by recent studies. With preemptive therapy， the EB virus related mortality had been decreased， but the time of intervention remains unclear. Rituximab and early reduction of immunosuppressive therapy are recommended as first-line treatment.Immunotherapy has achieved enormous progress as well. This article reviews literatures on the life cycle, risk factors，diagnosis and treatment of EB virus reactivation.

【Key word】 Epstein-Barr virus infections Hematopoietic stem cell transplantation； Immunosuppressive agents； Immunotherapy

Fund program: General Program of National Natural Science Foundation of China (81570105)