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Updated: Jan 10, 2026
Isolation and Quantification of Epstein-Barr Virus from the P3HR1 Cell Line
Published on: September 28, 2022
Active Epstein-Barr virus infection and its association with multiple myeloma: evidence from a meta-analytical
Zhimei Wu1, Huiye Yang1, Yongrong Lai2
1Department of Hematology, The First Affiliated Hospital of Guilin Medical University, Guilin, People's Republic of China.
Objectives:
To clarify the association between active Epstein-Barr virus (EBV) infection and the risk of multiple myeloma (MM), given longstanding uncertainty regarding EBV's etiologic contribution to plasma cell malignancies.
Methods:
A meta-analysis was conducted using eight case-control studies comprising 795 MM patients and 367 controls. Active EBV infection was defined as EBV DNA positivity or EBER detection by in situ hybridization (EBER-ISH). Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed-effects and random-effects models (DerSimonian and Laird method). Subgroup analyses were performed by geographic region, detection method, and study quality. Heterogeneity, sensitivity analyses, and trial sequential analysis (TSA) were conducted to assess robustness.
Results:
Active EBV infection was significantly associated with an increased risk of MM (OR = 2.30; 95% CI: 1.72-3.08; P < 0.001), with moderate heterogeneity (I2 = 36.9%). Stronger associations were observed among studies conducted in East Asian populations (OR = 2.99; 95% CI: 2.05-4.36; I2 = 0%) and in those using EBER-ISH for viral detection (OR = 2.98; 95% CI: 1.63-5.43; I2 = 0%). Analyses restricted to high-quality studies (Newcastle-Ottawa Scale ≥7) yielded consistent results (OR = 2.90; 95% CI: 2.00-4.20). Sensitivity analyses and TSA supported the stability and sufficiency of the evidence.
Discussion:
The findings provide quantitative support for a potential role of EBV in MM pathogenesis, particularly in specific populations and when assessed using sensitive histopathologic methods. Although causality cannot be inferred from case-control designs, the consistent effect sizes across subgroups and robustness analyses strengthen the plausibility of a biological link between EBV reactivation and clonal plasma cell expansion. Variations in viral detection approaches, population background, and study quality may partially explain interstudy differences.
Conclusion:
This meta-analysis demonstrates a significant association between active EBV infection and increased MM risk. These results highlight the clinical relevance of monitoring EBV activity in patients with plasma cell dyscrasias and support further mechanistic and translational research to evaluate EBV-targeted preventive or therapeutic strategies in the context of MM.
Insights
Active Epstein-Barr virus (EBV) infection is linked to a higher risk of multiple myeloma (MM). This meta-analysis suggests EBV may play a role in MM development, especially in certain populations.
Area of Science:
- Oncology
- Virology
- Epidemiology
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus with a complex relationship to various cancers.
- The specific role of active EBV infection in the pathogenesis of plasma cell malignancies, such as multiple myeloma (MM), remains uncertain.
Purpose of the Study:
- To quantitatively assess the association between active EBV infection and the risk of developing multiple myeloma (MM).
- To clarify the potential etiologic contribution of EBV to plasma cell malignancies.
Main Methods:
- A meta-analysis was performed on eight case-control studies, including 795 MM patients and 367 controls.
- Active EBV infection was defined by EBV DNA positivity or EBER in situ hybridization (EBER-ISH).
- Pooled odds ratios (ORs) and confidence intervals (CIs) were calculated, with subgroup, sensitivity, and trial sequential analyses (TSA) conducted for robustness.
Main Results:
- Active EBV infection showed a significant association with increased MM risk (OR = 2.30; 95% CI: 1.72-3.08).
- Stronger associations were found in East Asian populations and studies using EBER-ISH.
- High-quality studies and TSA confirmed the robustness of the findings.
Conclusions:
- This meta-analysis provides quantitative evidence supporting a potential role for EBV in MM pathogenesis.
- The findings underscore the clinical relevance of monitoring EBV activity in plasma cell disorders.
- Further research into EBV-targeted strategies for MM prevention and treatment is warranted.
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