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. 2025 Apr 29;113(1):86-93.
doi: 10.4269/ajtmh.24-0857. Print 2025 Jul 2.

Epstein-Barr Virus Seroprevalence in Thailand: A Temporal and Global Perspective with Health Care and Economic Correlations

Lita Tantipraphat  1   2 , Narakit Sudhinaraset  1   2 , Thanunrat Thongmee  1 , Sitthichai Kanokudom  1 , Pornjarim Nilyanimit  1 , Natthinee Sudhinaraset  1 , Yong Poovorawan  1   3
Affiliations

Epstein-Barr Virus Seroprevalence in Thailand: A Temporal and Global Perspective with Health Care and Economic Correlations

Lita Tantipraphat et al. Am J Trop Med Hyg. .

Abstract

Epstein-Barr virus (EBV) infects over 90% of the global population and establishes lifelong persistence. Although early childhood infections are often asymptomatic, EBV infection during adolescence can cause infectious mononucleosis, several malignancies, and posttransplant lymphoproliferative disorders. The timing of EBV infection and seroprevalence varies globally based on geographic and socioeconomic factors; however, comprehensive and updated data for Thailand are limited. This study investigated EBV seroprevalence across age groups in four provinces representing Thailand's regions, comparing findings with previous data and exploring correlations with economic and health care indicators. Serum samples (N = 1,274) were collected between May and August 2024 from participants ages 6 months old to 80 years old in Ayutthaya, Uttaradit, Buri Ram, and Trang provinces. EBV capsid antigen IgG levels were measured using ELISA. Age-specific seroprevalence increased from 35.9% in infants (6 months old to 2 years old) to nearly 100% in adolescents and adults, with varying antibody levels between age groups. Comparisons with historical data illustrated consistent trends of early EBV acquisition in childhood, but the infection increased slightly slower than in the past. Compared with other countries, EBV seroprevalence in Thailand and other developing countries occurred earlier than in developed countries. Linear regression analysis revealed a significant correlation between age at 50% and 75% EBV seropositive and a national economic indicator (gross domestic product per capita). These findings found little changes in EBV epidemiology over time and provided updated information and analysis to support public health strategies.

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Conflict of interest statement

Disclosures: The authors declare no conflicts of interest. The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Authors’ contributions: All authors were involved in the conception and design of the study. S. Kanokudom and P. Nilyanimit collected specimens and data. L. Tantipraphat and T. Thongmee performed the laboratory tests. L. Tantipraphat, Narakit Sudhinaraset, and Natthinee Sudhinaraset analyzed the data. L. Tantipraphat, Narakit Sudhinaraset, and S. Kanokudom developed visualization of the data. L. Tantipraphat, Narakit Sudhinaraset, Natthinee Sudhinaraset, and Y. Poovorawan drafted the manuscript. All authors critically revised the manuscript for intellectual content and approved the version to be published. All authors agree to be accountable for all aspects of the work.

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