Henry Balfour, Jr, MD

Professor, Department of Laboratory Medicine and Pathology

Henry Balfour, Jr

Contact Info


Office Phone 612-625-3998

Office Address:
15-144 P W B
516 Delaware St SE

Mailing Address:
Mayo Mail Code 609
420 Delaware Street SE
Minneapolis , MN 55455

Professor, Department of Laboratory Medicine and Pathology

Department of Pediatrics

Division of Pediatric Infectious Diseases and Immunology

MD, Columbia University, New York, NY

Residency in Pediatrics, Columbia-Presbyterian Medical Center, New York, NY

Fellowship in Pediatric Infectious Diseases, University of Minnesota Medical School, Minneapolis, MN

AB, Princeton University, Princeton, NJ


Dr. Balfour is a professor of laboratory medicine and pathology and also pediatrics. He is founder of the Clinical Virology Laboratory and is principal investigator of its International Center for Antiviral Research and Epidemiology. Balfour has a long-standing research interest in viruses and human disease and preventative vaccines. His current research focus is on the pathobiology of Epstein-Barr virus (EBV) and the development of an EBV vaccine.  Balfour is principal investigator of the Epstein-Barr Diseases Research Program.

A member of the herpes virus family, EBV is one of the most common human viruses and probably the most complex in terms of how it interacts with the immune system. Most people around the world get infected with EBV at some point in their lives. EBV spreads most commonly through bodily fluids, primarily saliva. EBV can cause infectious mononucleosis and is associated with Hodgkin’s lymphoma, Burkitt’s lymphoma and other cancers. EBV is a risk factor for blood and bone marrow transplant patients and others who are immunosuppressed. In addition, evidence that EBV plays a role in the pathogenesis of multiple sclerosis is rapidly accumulating.

Because EBV interacts with the immune system in complex ways, Balfour and other faculty in his virology group work closely with faculty in the Center for Immunology. Together they conducted a prospective study of University undergraduate students without evidence of EBV infection to determine the incidence of and risk factors for the acquisition of primary EBV. They found that 25 percent of freshmen lacking evidence of EBV in their bloodstream are subsequently infected and acquire mononucleosis. EBV infection is associated with deep kissing with nearly nine of ten infected students showing symptoms. The researchers also found that the severity of symptoms is related to high numbers of natural killer cells, CD8+ T cells, and elevated blood viral loads. People with a history of mononucleosis are at higher risk for developing Hodgkin’s lymphoma and also multiple sclerosis (MS), a central nervous system disease that affects more than two million people worldwide. Nearly all MS patients possess EBV antibodies indicating acquisition of the virus.

Balfour and his colleagues together with a private company are working to develop a vaccine that could potentially prevent EBV-caused diseases like mononucleosis and EBV-associated diseases like Hodgkin’s lymphoma and MS. A vaccine could also potentially prevent severe illness or even death from EBV infection following transplantation, especially in pediatric patients who have not been exposed to the virus and have no antibodies against it. The investigators are targeting the EBV viral-surface glycoprotein 350 (gp350), which can prevent EBV from entering the cell. Because gp350 is the most highly expressed of EBV surface proteins, neutralizing antibody is developed in concert with recognizing the gp350 molecule. The experimental vaccine will be based on gp350 protein that can raise neutralizing antibody, which in turn prevents EBV from traveling from one cell to another once EBV infection occurs.

Balfour is Associate Editor of the Journal of Clinical Virology.

Awards & Recognition

  • Clinical Scholar Award, University of Minnesota Medical Center, Fairview, (2005)
  • Biographee, Who's Who in: America, (1986 - present); the World, (1989 - present)
  • Merck Manual Award, Columbia College of Physicians and Surgeons, (1966)


Research Summary/Interests

Diagnosis and treatment of herpesvirus infections; pathobiology of Epstein-Barr virus (EBV) diseases; role of EBV in infectious mononucleosis, non-Hodgkin's lymphoma, multiple sclerosis, and organ transplantation; EBV vaccine development. 


See also PubMed

Selected Publications

  • Geris JM, Duval LM, and Balfour HH. “Epstein-Barr Virus.” In: Rezaei N (ed.) Encyclopedia of Infection and Immunity. vol. 2, pp. 37-52. Oxford: Elsevier (2022). dx.doi.org/10.1016/B978-0-12-818731-9.00074-4.
  • Fahad AS, Cheng-Yu C, Lopez Acevedo SN, Boyle N, Madan B, Gutiérrez-González M-F, Matus-Nicodemos R, Laflin AD, Ladi RR, Zhou J, Wolfe J, Llewellyn-Lacey S, Koup RA, Douek DC, Balfour HH Jr, Price DA, and DeKosky BJ. Immortalization and functional screening of natively paired human T cell receptor repertoires, Protein Engineering, Design and Selection, Volume 35, 2022, gzab034, https://doi.org/10.1093/protein/gzab034
  • Liu H, Gemmell L, Lin R, Zuo F, Balfour HH Jr, Woo JC, Hayes GM. Development of an improved Epstein-Barr Virus (EBV) neutralizing antibody assay to facilitate development of a prophylactic gp350-subunit EBV vaccine. Mediterr J Hematol Infect Dis. 2020 Mar 1;12(1):e2020016. doi: 10.4084/MJHID.2020.016.
  • Allen Choi, Kathryn Marcus, Danielle Pohl, Patrick Ten Eyck, Henry Balfour Jr, and J Brooks Jackson. Epstein-Barr virus infection status among first year undergraduate university students. Journal of American College Health, Feb. 2, 2019. https://doi.org/10.1080/07448481.2020.1726927
  • Rostgaard K, Balfour HH Jr, Jarrett R, Erikstrup C,Pedersen O, Ullum H,, Nielsen LP, Voldstedlund M, Hjalgrim H. Primary Epstein-Barr virus infection with and without infectious mononucleosis.PLoS One. 2019 Dec 17;14(12):e0226436. doi: 10.1371/journal.pone.0226436. 
  • Balfour HH Jr, Schmeling DO, Grimm-Geris JM. The promise of a prophylactic Epstein-Barr virus vaccine. Pediatr Res. 2019 Oct 3. doi: 10.1038/s41390-019-0591-5.
  • Cederberg LM, Rabinovitch MD, Grimm-Geris JM, Schmeling DO, Filtz EA, Condon LM, Balfour HH Jr. Epstein-Barr virus DNA in parental oral secretions: a potential source of infection for their young children. Clin Infect Dis 2018; DOI: 10.1093/cid/ciy464
  • Dunmire SK, Verghese PS, Balfour HH Jr. Primary Epstein-Barr virus infection. Journal of Clinical Virology 103(2018) 84-92. https://goo.gl/yJTNbg
  • Samantha K. Dunmirea, Priya S. Vergheseb, Henry H. Balfour Jr.  Primary Epstein-Barr virus infection.  J Clinical Virology 2018 102: 84-92.   DOI: https://doi.org/10.1016/j.jcv.2018.03.001
  • Verghese PS, Schmeling DO, Grimm JM, Filtz EA, Matas AJ, Balfour HH Jr. Transplantation of solid organ recipients shedding Epstein-Barr virus DNA pretransplant: a prospective study. Clin Transplant 2017. DOI: 10.1111/ctr.13116 https://www.ncbi.nlm.nih.gov/pubmed/28915342
  • JM Grimm, DO Schmeling, SK Dunmire, JA Knight, BD Mullan, JA Ed, RC Brundage, KA Hogquist and HH Balfour Jr. “Prospective studies of infectious mononucleosis in university students,” Clinical & Translational Immunology (2016) 5, e94; doi:10.1038/cti.2016.48. 
  • Balfour HH Jr, Hogquist KA, Verghese P. Epstein-Barr virus and cytomegalovirus. In: Detrick B, Schmitz JL, Hamilton RG, eds. Manual of Molecular and Clinical Laboratory Immunology, eighth edition, ASM Press 2016.DOI 10.1128/9781555818722.
  • Balfour HH Jr. Epstein-Barr virus vaccine. In: Plotkin SA, Orenstein W, Offit PA, Edwards KM eds. Vaccines, 7th edition. Elsevier 2016.
  • Johnson KH, Webb C-H, Schmeling DO, Brundage RC and Balfour HH Jr. Epstein–Barr virus dynamics in asymptomatic immunocompetent adults: an intensive 6-month study. Clinical & Translational Immunology 2016. DOI:10.1038/cti.2016.28. Published online 13 May 2016
  • Balfour HH Jr, Odumade OA, Schmeling DO, Mullan BD, Ed JA, Knight JA, Vezina HE, Thomas W, Hogquist KA. Behavioral, virologic, and immunologic factors associated with acquisition and severity of primary Epstein-Barr virus infection in university students. J Infect Dis 2013; 207:80-8. PMCID:PMC3523797
  • Balfour HH Jr, Sifakis F, Sliman JA, Knight JA, Schmeling DO, Thomas W. Age-specific prevalence of Epstein-Barr virus (EBV) infection among children in the United States and factors affecting its acquisition. J Infect Dis 2013;208:1286-93. DOI 10.1093/infdis/jit321
  • Condon LM, Cederberg LE, Rabinovitch MD, Liebo R, Go JC, Delaney, AS, Schmeling DO, Thomas W, Balfour HH Jr. Age-Specific prevalence of Epstein-Barr virus infection among Minnesota children: effects of race/ethnicity and family environment. Clin Infect Dis 2014;59:511-8. DOI 10.1093/cid/ciu342
  • Verghese PS, Schmeling DO, Knight JA, Matas AJ, Balfour HH Jr. The impact of donor viral replication at transplant on recipient infections posttransplant: a prospective study. Transplantation 2015; 99:602-8. DOI 10.1097/TP.0000000000000354

Invited Lectures

  • Feb 15, 2012. Laboratory Medicine and Pathology Grand Rounds (with Kris Hogquist), University of Minnesota: "Mono: A Disease for All Seasons."
  • July 30-31, 2012. Attended an NCI Burkitt Lymphoma Workshop, Philadelphia PA and gave a talk: "Prophylactic Vaccine (gp350) for EBV."
  • February 6, 2013. Pediatric Grand Rounds, University of Minnesota: Epstein-Barr Virus and Infectious Mononucleosis: What Students Can Teach Us."
  • April 8, 2013. 39th European Group for Blood & Bone Marrow Transplantation meeting, London, England: "What Bugs to Monitor: EBV?"


  • Balfour HH Jr, Hogquist KA, Holman CJ, Schmeling DO, Mullan BD, Ed JA, Odumade OA, Thomas W, Vezina HE. A prospective study of primary Epstein-Barr virus infection. Presented at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, IL, September 18, 2011. Abstract V494.
  • Verghese P, Ed J, Mullan B, Knight J, Balfour HH Jr. Prospective study of Epstein-Barr virus (EBV), cytomegalovirus (CMV) and BK virus (BKV) infections in solid organ donors and recipients. Presented at the American Transplant Congress, Boston, MA, June 5, 2012.
  • Bu W, Schmeling DO, Burbelo PD, Radecki P, Balfour HH Jr, Cohen JI. Neutralizing antibody titers increase over many months to years after Epstein-Barr virus infectious mononucleosis. Presented at the International Congress on Oncogenic Herpesviruses and Associated Diseases, Philadelphia, PA, August 2, 2012.
  • Condon LM, Rabinovitch MD, Cederberg LE, Liebo RV, Delaney AS, Balfour HH Jr. Age-specific Epstein-Barr virus (EBV) antibody (Ab) prevalence and risk factors for early acquisition of infection. Presented at the 52st Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, CA, September 11, 2012.
  • Balfour HH Jr, Sifakis F, Sliman JA, Knight JA, Schmeling DO, Thomas W. Age-specific prevalence of Epstein-Barr Virus (EBV) antibody (Ab) in US children: Results from the National Health and Nutrition Examination Surveys (NHANES) 2003-2010. Presented at the 52st Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, CA, September 11, 2012. Abstract V1242a. In: ICAAC 2012 Final Program, pp222-3.
  • Wang Y, Stanford SM, Zhou W, Auger JL, Cheng G, Shoyama FM, Balfour HH Jr, Chan AC, Binstadt BA, Bottini N, Peterson EJ. Rheumatoid arthritis-associated PTPN22 promotes Toll-like receptor-driven upregulation of type 1 interferon and innate immunoregulation. Presented at the annual meeting of the American College of Rheumatology, November 13, 2012, Washington, DC.
  • Balfour HH Jr. Which bugs should we monitor: EBV? Presented at the 39th annual meeting of the European Group for Blood and Marrow Transplantation. London, UK, April 8, 2013.
  • Chandolias N, Gillingham KJ, Balfour HH Jr, Matas AJ. Impact of donor and recipient pretransplant EBV antibody status on PTLD incidence in adult kidney transplant recipients. Presented at the American Transplant Congress, Seattle, May 21, 2013.
  • Dunmire SK, Odumade OA, Porter JL, Reyes-Genere J, Baechler EC, Balfour HH Jr, Hogquist KA. Primary EBV infection induces an expression profile distinct from other viruses but similar to hemophagocytic syndromes. Presented at the EBV 50th Anniversary Meeting. Oxford, UK, March 24, 2014.
  • Reed RC, Schmeling DO, Balfour HH Jr. Cytomegalovirus infection masquerading as necrotizing enterocolitis and ischemic colitis. Presented at the spring meeting of the Society for Pediatric Pathology, Boston, MA, March 21, 2015.
  • Cederberg LE, Rabinovitch MD, Grimm JM, Schmeling DO, Filtz EA, Condon LM, Balfour HH Jr. Prevalence of Epstein-Barr virus (EBV) oral shedding among parents of young children differs significantly by race/ethnicity. Presented at the 55th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA, September 19, 2015.
  • Grimm JM, Schmeling DO, Cayatte C, Hayes GM, Balfour HH Jr. Rapid Epstein-Barr virus (EBV) antibody (Ab) responses correlate with reduced severity of primary EBV infection. Presented at the 55th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA, September 19, 2015.


Board Certifications

  • American Board of Pediatrics