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Viral exposures and MS outcome in a prospective cohort of children with acquired demyelination

Naila Makhani1, Brenda Banwell2, Raymond Tellier3

  • 1Departments of Pediatrics and Neurology, Yale University School of Medicine, USA naila.makhani@yale.edu.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 23, 2015
PubMed

Insights

Epstein-Barr virus (EBV) infection increases multiple sclerosis (MS) risk, while cytomegalovirus (CMV) may be protective. The combination of EBV without CMV in children with acquired demyelinating syndromes indicates a higher risk for developing MS.

Area of Science:

  • Neuroimmunology
  • Viral Immunology
  • Pediatric Neurology

Background:

  • Epstein-Barr virus (EBV) is a known risk factor for multiple sclerosis (MS).
  • Cytomegalovirus (CMV) has been recently investigated as a potential protective factor against MS development.
  • Understanding the interplay of viral infections in early life is crucial for predicting neurological disease trajectories.

Purpose of the Study:

  • To investigate the seroprevalence of Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus, and varicella-zoster virus in children with acquired demyelinating syndromes (ADS).
  • To determine if specific viral infection patterns are associated with the subsequent diagnosis of multiple sclerosis (MS) versus monophasic ADS.
  • To assess the prognostic value of viral infection serostatus in pediatric ADS.

Main Methods:

  • Prospective cohort study of 247 children diagnosed with acquired demyelinating syndromes (ADS).
  • Serological testing for Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus, and varicella-zoster virus.
  • Comparison of viral seroprevalence between children who developed MS and those with monophasic ADS.

Main Results:

  • Remote EBV infection was more prevalent in children who later developed MS compared to those with monophasic ADS.
  • CMV infection was more common in children with monophasic ADS.
  • Children with evidence of remote EBV infection but without CMV infection exhibited the highest risk for subsequent MS diagnosis.

Conclusions:

  • The viral infection repertoire in children with ADS offers significant prognostic information.
  • The presence of EBV without concurrent CMV infection is a key indicator of elevated MS risk in pediatric populations.
  • Early viral infection patterns can help stratify risk for developing multiple sclerosis.
Keywords:
Epstein–Barr virusMultiple sclerosiscytomegaloviruspediatricrisk factors

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