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s / International Journal of Infectious Diseases 73S (2018) 3–398 373 even in patients undergoing primary infection or viral reactivation (pï¿1⁄2>ï¿1⁄20.05, Fisher exact test). Conclusion: In adults undergoing EBV primary infection with symptoms, high viral load together with latency III pattern and lytic antigen expression was described. In contrast, in our primary infected patients the lack of symptoms could be related to a low viral inoculum, together with the absence of latency III and lytic viral antigens. Furthermore, viral characteristics in the primary infected group are similar to patients with viral reactivation and healthy carriers. In addition, lower viral load in older patients may reflect a recruitment of immune cells to successfully control EBV infection at the site of viral entry and reactivation, perhaps as a consequence of maturity of the immune system. https://doi.org/10.1016/j.ijid.2018.04.4256