Multiple Sclerosis and Epstein-Barr Virus

Abstract

OBJECTIVE:To evaluate the epidemiological evidence for an etiological role of Epstein-Barr virus in multiple sclerosis (MS). DATA SOURCES: MEDLINE and Cochrane Library searches of the medical literature identified 24 studies. DATA EXTRACTION: Studies were categorized as seroepidemiological, case-control or historical cohort, and were then classified within each group according to methodological rigour using criteria derived from published guidelines for the epidemiological study of MS. DATA SYNTHESIS: There was significant variability in the quality of evidence, and while two well-designed cohort studies found increased relative risks of MS in subjects with infectious mononucleosis, results from other studies were unconvincing. CONCLUSIONS: The evidence was insufficient to accept or reject the hypothesis that Epstein-Barr virus has an etiological role in MS. Further study, ideally using large samples of incident cases with blinded, trained interviewers using confirmatory sources for recalled data, is needed. EXTRACTION DES DONNÉES :Les études ont d'abord été divisées en trois catégories : séro-épidémiologiques, cas/témoins et cohortes antérieures, puis classées, dans chacun des groupes, en fonction de leur rigueur méthodologique selon des critères définis dans des lignes directrices publiées concernant l'étude épidémiologique de la SP. SYNTHÈSE DES DONNÉES : Des écarts importants ont été notés relativement à la qualité des données; deux études de cohortes, bien conçues, ont fait ressortir des risques relatifs accrus de SP chez les sujets ayant subi une mononucléose infectieuse, tandis que les résultats des autres études n'étaient pas concluants. CONCLUSION : Nous ne disposons pas suffisamment de données pour confirmer ou infirmer l'hypothèse selon laquelle le virus EpsteinBarr joue un rôle étiologique dans la SP. Il faudrait donc poursuivre l'étude, idéalement à partir de grands échantillons de cas nouveaux et en faisant appel à des intervieweurs formés et tenus dans l'ignorance, qui utilisent des sources de confirmation pour le rappel des données.

Human herpes virus 6 and multiple sclerosis

“…Ratings of methodological rigor were applied using criteria derived from published guidelines for the epidemiological study of MS (26; Appendix 1). These criteria have been used previously (27, 28), but have not yet been assessed for reliability. They were designed to facilitate the comparison of different studies by providing a qualitative impression of the soundness of the study design and methods.…”

Relation between Epstein-Barr virus and multiple sclerosis: analytic study of scientific production

“…The work of Holmøy [14] concluded that vitamin D deficiency and EBV infection are both very common population-wide events, and could be involved in MS pathogenesis. Finally, other authors [5,15] in two well-designed cohort studies found increased relative risks of MS in subjects with IM, but the results from other studies were unconvincing [16].…”

Alemtuzumab: A Place in Therapy for Treatment of Multiple Sclerosis

“…Viral infections have long been an area of interest as precipitating factors of MS. Studies have evaluated an association with childhood viral infections including measles, mumps, rubella and varicella, but data have failed to demonstrate a link to MS development [10]. Epstein-Barr virus (EBV) has gained the most interest as a potential environmental factor for MS. An increased EBV antibody seroprevalence has been found to occur in MS patients compared to controls [11,12]. While current evidence is not sufficiently robust to confirm an increased risk of developing MS in patients with prior EBV infection, research of the association remains plausible [11,[13][14][15].…”