The Epstein–Barr virus (EBV) is a DNA lymphotropic herpesvirus and the causative agent of infectious mononucleosis. EBV is highly prevalent since it affects more than 90% of individuals worldwide and has been linked to several malignancies including PTLDs, which are one of the most common malignancies following transplantation.

Among all the EBV genes, most of the recent investigations focused on studying the LMP-1 oncogene because of its high degree of polymorphism and association with tumorigenic activity. There are two main EBV genotypes, Type 1 and 2, distinguished by the differences in the EBNA-2 gene.

Further sub-genotyping can be characterized by analyzing the LMP-1 gene variation. The virus primarily transmits through oral secretions and persists as a latent infection in human B-cells. However, it can be transmitted through organ transplantations and blood transfusions.

In addition, symptoms of EBV infection are not distinguishable from other viral infections, and therefore, it remains questionable whether there is a need to screen for EBV prior to blood transfusion. Although the process of leukoreduction decreases the viral copies present in the leukocytes, it does not eliminate the risk of EBV transmission through blood products.

Here, we provide a review of the EBV epidemiology and the genetic variability of the oncogene LMP-1. Then, we underscore the findings of recent EBV seroprevalence and viremia studies among blood donors as a highly prevalent transfusion transmissible oncovirus.

The Epstein–Barr Virus (EBV), also called human herpesvirus 4, is a lymphotropic herpesvirus and the causative agent of infectious mononucleosis (IM)). It was first discovered in cells isolated from African Burkitt’s lymphoma, later, it was recognized that it is highly prevalent worldwide. Similar to other herpesviruses, following a primary infection, the EBV has a latency phase where it infects epithelial cells, enters the circulating B lymphocyte, and persists for the life in a latent state. According to epidemiological studies, EBV is estimated to be positive in more than 90% of the world’s population. Typically, the primary infection is asymptomatic and occurs during childhood.

However, the infection could lead to IM if it occurs in adults. In addition, this virus has been linked to a wide range of malignancies, such as posttransplant lymphoproliferative diseases (PTLDs), nasopharyngeal carcinoma (NPC), Hodgkin’s lymphoma, and gastric carcinoma (MS).