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Primary infection with the Epstein-Barr virus and risk of multiple sclerosis

Lynn I Levin1, Kassandra L Munger, Eilis J O'Reilly

  • 1Department of Epidemiology, Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, MD, USA.

Annals of Neurology
|June 3, 2010
PubMed

Insights

Multiple sclerosis (MS) risk is very low without Epstein-Barr virus (EBV) infection. However, the risk of developing MS sharply increases after primary EBV infection in individuals.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease with increasing incidence.
  • The role of Epstein-Barr virus (EBV) in MS pathogenesis remains a significant area of research.
  • Understanding the temporal relationship between EBV infection and MS onset is crucial for prevention and treatment strategies.

Purpose of the Study:

  • To investigate the association between primary Epstein-Barr virus (EBV) infection and the subsequent risk of developing multiple sclerosis (MS).
  • To determine if EBV seroconversion precedes the onset of MS.

Main Methods:

  • A nested case-control study design was employed.
  • Serum samples from over 8 million active-duty military personnel were analyzed.
  • Cases (n=305) who developed MS were matched with controls (n=610) based on demographic and military service data.
  • Serial serum samples were tested for EBV antibody titers to determine the timing of primary infection.

Main Results:

  • A small proportion of individuals in both case and control groups were initially EBV-negative.
  • All EBV-negative cases seroconverted to EBV-positive prior to MS onset.
  • In contrast, a significantly lower proportion of EBV-negative controls seroconverted during the follow-up period (p=0.0008).

Conclusions:

  • The risk of developing MS is minimal in individuals uninfected with EBV.
  • Primary EBV infection is strongly associated with a sharp increase in MS risk.
  • These findings highlight EBV as a critical factor in the development of multiple sclerosis.

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