The Economic Burden of Epstein–Barr Virus Infection in the Russian Federation

Introduction: Epstein–Barr virus-related diseases are of great medical and social importance, which requires assessment of economic losses due to costs of medical care and sickness absenteeism.

Objective: To propose a methodology for assessing economic damage and to use it for quantification of total damages caused by Epstein–Barr virus (EBV) infections in the Russian Federation in 2022.

Materials and methods: The economic damage from EBV infections was determined using official statistics (2022) on cases of infectious mononucleosis, upper respiratory tract infections, cardiac arrhythmias, atopic dermatitis, dorsopathy, chronic tonsillitis in the acute phase, cerebrovascular disease, psoriasis, and multisystem inflammatory syndrome associated with COVID-19.

Results: Based on the methodology for assessing economic damages described in the article, we found that the total financial losses from EBV-associated diseases in the Russian Federation in 2022 amounted to 1,203.0 billion rubles, which is significantly higher than similar values for all other registered infectious diseases with the exception of COVID-19. COVID-19-related multisystem inflammatory syndrome, upper respiratory tract infections, and cerebrovascular disease accounted for more than 90 % of all losses. The structure of total costs was dominated by indirect economic losses (1,096.75 billion rubles or 91.2 %) due to sickness absence from work.

Conclusion: The findings allow us to outline directions of developing measures to reduce the economic damage from EBV-associated diseases.

1. Bu GL, Xie C, Kang YF, Zeng MS, Sun C. How EBV infects: The tropism and underlying molecular mechanism for viral infection. Viruses. 2022;14(11):2372. doi: 10.3390/v14112372

2. Kerr JR. Epstein Barr virus (EBV) reactivation and therapeutic inhibitors. J Clin Pathol. 2019;72(10):651-658. doi: 10.1136/jclinpath-2019-205822

3. Svitich OA, Zverev VV, Solomay TV, Semenenko TA, Nozdracheva AV, Gotvyanskaya TP. Possibilities of a biobank for serological monitoring of infectious morbidity. Kardiovaskulyarnaya Terapiya i Profilaktika. 2023;22(11):99-105. (In Russ.) doi: 10.15829/1728-8800-2023-3693

4. Popkova MI, Utkin OV, Soboleva EA, Filatova EN, Bryzgalova DA, Sakharnov NA. The clinical and laboratory characteristics of infectious mononucleosis caused by the Epstein-Barr virus type 1 in hospitalized children. Zhurnal Infektologii. 2023;15(1):36-47. (In Russ.) doi: 10.22625/2072-6732-2023-15-1-36-47

5. Bravender T. Epstein-Barr virus, cytomegalovirus, and infectious mononucleosis. Adolesc Med State Art Rev. 2010;21(2):251-64, ix.

6. Melekhina EV, Gorelov AV. On the problem of clinical classification of infection associated with human herpesvirus 6A/B in children. Infektsionnye Bolezni. 2020;18(1):5-16. (In Russ.) doi: 10.20953/1729-9225-2020-1-5-16

7. Yang T, You C, Meng S, Lai Z, Ai W, Zhang J. EBV infection and its regulated metabolic reprogramming in nasopharyngeal tumorigenesis. Front Cell Infect Microbiol. 2022;12:935205. doi: 10.3389/fcimb.2022.935205

8. Pyo JS, Kim NY, Kang DW. Prognostic implication of EBV infection in gastric carcinomas: A systematic review and meta-analysis. Medicina (Kaunas). 2023;59(5):834. doi: 10.3390/medicina59050834

9. Soldan SS, Lieberman PM. Epstein-Barr virus and multiple sclerosis. Nat Rev Microbiol. 2023;21(1):51-64. doi: 10.1038/s41579-022-00770-5

10. Tangye SG. Genetic susceptibility to EBV infection: Insights from inborn errors of immunity. Hum Genet. 2020;139(6-7):885-901. doi: 10.1007/s00439-020-02145-3

11. Solomay TV, Semenenko TA, Filatov NN, Kolbutova KB, Oleinikova DYu, Karazhas NV. The role of children and adults as a reservoir of pathogens during the seasonal rise in the incidence of upper respiratory tract infections. Detskie Infektsii. 2020;19(3):5-11. (In Russ.) doi: 10.22627/2072-8107-2020-19-3-5-11

12. Solomay TV, Semenenko TA, Filatov NN, et al. Risk of circulatory diseases on the example of heart rhythm disorders in patients with serological markers of Epstein-Barr infection. Health Risk Analysis. 2021;(3):146-155. doi: 10.21668/health.risk/2021.3.15.eng

13. Solomay TV, Semenenko TA, Isaeva EI, Vetrova EN. The role of active Epstein-Barr viral infection in the development of cerebrovascular diseases. Epidemiologiya i Infektsionnye Bolezni. Aktual’nye Voprosy. 2022;12(2):34-41. (In Russ.) doi: 10.18565/epidem.2022.12.2.34-41

14. Solomay TV, Semenenko TA, Vedunova SL, Isaeva EI, Vetrova EN, Karazhas NV. The role of active herpesvirus infection in the formation of atopic dermatitis and psoriasis. Sibirskiy Nauchnyy Meditsinskiy Zhurnal. 2022;42(3):94-102. (In Russ.) doi: 10.18699/SSMJ20220312

15. Solomay TV, Semenenko TA, Filatov NN, et al. Reactivation of Epstein–Barr virus (Herpesviridae: Lymphocryptovirus, HHV-4) infection during COVID-19: Epidemiological features. Voprosy Virusologii. 2021;66(2):152-161. (In Russ.) doi: 10.36233/0507-4088-40

16. Mikheeva MA, Mikheeva IV. Ranking dynamics of economic burden of infectious diseases as a criterion of effectiveness of epidemiologic control. Zhurnal Mikrobiologii, Epidemiologii i Immunobiologii. 2020;97(2):174-181. (In Russ.) doi: 10.36233/0372-9311-2020-97-2-174-181

17. Shakhanina IL, Osipova LA. Economic losses due to infective diseases in Russia: Sizes and trends. Epidemiologiya i Infektsionnye Bolezni. 2005;(4):19-21. (In Russ.)

18. Sokolova OV, Ushakova TN, Zykova NV, Buzinov RV, Tokarevich NK. The assessment of economic damage from tick-borne encephalitis based on potential years of life lost. Sotsial’nye Aspekty Zdorov’ya Naseleniya. 2023;69(3):12. (In Russ.) doi: 10.21045/2071-5021-2023-69-3-12

19. Ivanova AV, Safronov VA, Zubova AA, et al. Methodological approaches to assessing the economic damage associated with the incidence of hemorrhagic fever with renal syndrome in the Russian Federation. Problemy Osobo Opasnykh Infektsiy. 2023;(1):96-104. (In Russ.) doi: 10.21055/0370-1069-2023-1-96-104

20. Bobrovitskaya AI, Dubovaya AV, Lepikhova LP, Zakharova LA, Karachaeva ES. Some clinical and pathogenetic aspects of the primary form of Epstein-Barr viral infection in children. Voennaya i Takticheskaya Meditsina, Meditsina Neotlozhnykh Sostoyaniy. 2022;(2(5)):42-56. (In Russ.) doi: 10.55359/2782-3296.2022.81.55.006

21. Oradovskaya IV, Vikulov GKh, Kolobukhina LV, Malyshev NA, Antipyat NA. Herpesvirus infections in adult residents of Moscow: Incidence, prevalence, nosological forms and algorithm of management. Infektsionnye Bolezni. 2022;20(4):125-142. (In Russ.) doi: 10.20953/1729-9225-2022-4-125-142