463: Epstein Barr Virus (Ebv) Exposure Precedes Crohn's Disease Development

Risk of Inflammatory Bowel Disease Following Hospitalisation with Infectious Mononucleosis: A Danish Nationwide Cohort Study (1977-2021)

“…Furthermore, longitudinal analysis on the same cohort indicated this association may be putative as increased levels of EBV exposure were present as early as 5 years before disease diagnosis. 23 The vast majority of individuals are infected with EBV during childhood or adolescence, resulting in a persistent and mostly latent EBV infection, which most commonly manifests as IM, when primary infection occurs in adolescence. 16 A Danish study assessing age-dependent variations both in IM attack rates and EBV seroconversion hazard rates found 85% of the Danish population had seroconverted by age 30 years, 15 with peak incidence being in the 15-24 year age range.…”

“…To overcome the challenge of high EBV seroprevalence in detecting association with IBD Nandy et. al., 23 have recently attempted to apply unbiased, comprehensive serological viral screening to a small longitudinal cohort of 42 IBD patients with pre- and post-diagnostic serum samples. Authors show that EBV exposure levels are significantly associated with CD patients compared with healthy controls (CD=78.2% vs healthy controls=53.3%, p=0.045), suggesting a pathogenic role for EBV in either the onset or progression of CD.…”

“…Furthermore, longitudinal analysis on the same cohort indicated this association may be putative as increased levels of EBV exposure were present as early as 5 years before disease diagnosis. 23…”

“…22 Preliminary evidence from a study using a bacteriophage immunoprecipitation sequencing technique, like that used by Bjornevik et al, 2022, on a cohort of 119 military service personnel diagnosed with IBD and healthy matched controls, found that exposure to EBV was significantly associated with CD, supporting a biological association with EBV exposure and IBD development. 23 More recently, Loosen et al, 2023, 24 undertook a retrospective cohort study using data from a subset of German primary care physicians in the Disease Analyzer Database (IQVIA) to explore the association between general practitioner recorded IBD following IM diagnosis. Although authors observe a significant association with between IM and subsequent IBD, several limitations in study design, including short follow-up time, small cohort size and lack of population representative data (only from 3% of German primary care physicians were included in the analysis), and particularly a lack of clinical data on IM severity and presentation, and validity of IBD diagnoses make interpretation of these study findings challenging.…”