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Epstein–Barr virus pathogenesis and emerging control strategies

Nature Reviews Microbiology volume 23, pages 667–679 (2025)Cite this article

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Abstract

Sixty years after its discovery as the first human tumour virus, Epstein–Barr virus (EBV)-specific therapies and vaccines have entered clinical trials. These might not only be applicable for EBV-associated malignancies, where the virus was originally discovered, but also to immunopathologies, including the autoimmune disease multiple sclerosis, which might be triggered in susceptible individuals by primary EBV infection. This Review discusses the surprisingly large spectrum of diseases that EBV seems to cause, as well as which of these might be treated by the therapeutic approaches that are currently being developed or are already clinically applied. New pharmacological inhibitors, antibody therapies, adoptive T cell therapies and active vaccinations are beginning to offer possibilities to target the various EBV infection programmes that are associated with different diseases. These novel developments might allow us to specifically target EBV rather than its host cells in virus-associated pathologies.

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Fig. 1: EBV infection of B cells and epithelial cells during asymptomatic viral persistence.
Fig. 2: Requirements for EBV-specific immune control.
Fig. 3: EBV-associated tumours.
Fig. 4: EBV association with the autoimmune disease multiple sclerosis.
Fig. 5: Passive and active immunization targets of EBV.

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Acknowledgements

Research in the author’s laboratory is in part financially supported by the Swiss National Science Foundation (310030_204470/1 and CRSII_222718_10000065), Cancer Research Switzerland (KFS-5896-08-2023-R), the Swiss MS Society (2023-17), the Swiss State Secretariat for Education, Research and Innovation (SERI) for EU Horizon BEHIND-MS, the Sobek Foundation, the Swiss Vaccine Research Institute, the Vontobel Foundation, Roche and Pfizer.

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    Christian Münz

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Münz, C. Epstein–Barr virus pathogenesis and emerging control strategies. Nat Rev Microbiol 23, 667–679 (2025). https://doi.org/10.1038/s41579-025-01181-y

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