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Positive association of herpes simplex virus-IgG with multiple sclerosis: A systematic review and meta-analysis
Lu Xu1, Lin-Jie Zhang1, Li Yang1
1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
Background:
Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system (CNS), and whether herpes simplex virus (HSV) infection is associated with the development of MS remains controversial. We aimed to investigate potential associations between MS or clinically isolated syndrome (CIS) and the prevalence of IgG and DNA for HSV in the clinical samples.
Methods:
A systematic search of English databases (PubMed, Embase and Cochrane Library) was performed. The prevalence of IgG against herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) and DNA for HSV-1 or HSV-2 in clinical samples were pooled and compared between patients with MS/CIS and controls using Stata 12.0.
Results:
A total of 1756 patients with MS/CIS and 6429 controls from eight studies were included. The pooled results showed a significantly statistical difference in the seroprevalence of IgG against HSV-2 (OR 1.764, 95% CI [1.410 to 2.206], P = 0.000) between patients with MS/CIS and controls. However, no significantly statistical difference was shown in the seroprevalence of IgG against HSV-1 (OR 1.166, 95% CI [0.737 to 1.845], P = 0.512) between patients with MS/CIS and controls. Similarly, there was no significantly statistical difference in the prevalence of HSV-1 DNA (OR 0.957, 95% CI [0.310 to 2.949], P = 0.938) and HSV-2 DNA in cerebrospinal fluid (CSF) and peripheral blood mononuclear cells (PBMC) (OR 0.506, 95% CI [0.022 to 11.416], P = 0.668) between patients with MS/CIS and controls. Subgroup analysis suggested that mean age at sampling might be a source of heterogeneity, and the seroprevalence of IgG against HSV-1 was significantly increased in the pediatric patients with MS/CIS (OR 1.488, 95% CI [1.130 to 1.959], P = 0.005), compared with the controls.
Conclusions:
The study demonstrated that prior HSV-1 infection might relate to the onset of pediatric MS/CIS and might not play a role in the development of adult MS. Furthermore, prior HSV-2 infection might have a correlation with MS/CIS. The mechanism remains to be further studied.
Insights
Herpes simplex virus type 2 (HSV-2) infection is correlated with multiple sclerosis (MS) or clinically isolated syndrome (CIS). Prior herpes simplex virus type 1 (HSV-1) infection may be linked to pediatric MS/CIS, but not adult MS.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Multiple sclerosis (MS) is a leading cause of neurological disability.
- The potential link between herpes simplex virus (HSV) infection and MS development is debated.
- Investigating HSV's role in MS and clinically isolated syndrome (CIS) is crucial.
Purpose of the Study:
- To determine the association between MS/CIS and the prevalence of IgG antibodies and DNA for HSV.
- To compare HSV seroprevalence and DNA presence in patients with MS/CIS versus healthy controls.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane Library.
- Pooled analysis of IgG and DNA prevalence for HSV-1 and HSV-2 in clinical samples.
- Statistical comparison between MS/CIS patients and controls using Stata 12.0.
Main Results:
- Increased seroprevalence of IgG against HSV-2 was observed in MS/CIS patients (OR 1.764).
- No significant difference in IgG against HSV-1 or HSV DNA prevalence between groups.
- Pediatric MS/CIS patients showed increased IgG against HSV-1 (OR 1.488), unlike adults.
Conclusions:
- HSV-2 infection may correlate with MS/CIS development.
- HSV-1 infection might be associated with pediatric MS/CIS onset, but not adult MS.
- Further research is needed to elucidate the underlying mechanisms.
