Clinical and virological observations in childhood Hodgkin's disease in Israel

Antibody levels to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) were determined in children with Hodgkin's disease (HD) before therapy, as well as in healthy, age-matched controls. Included were 21 Israeli-born children, aged 2.5 to 14.5 years: 13 Jews whose parents were of African-Asian origin, 1 Jew whose parents were of European origin, and 7 Arabs. Most of them were from large families (average 5.5 children per family) and low socioeconomic class. Antibody levels were not statistically different between patient and control groups with respect to CMV, HSV and VZV. Geometric mean titer of antibody to EBV viral capsid antigen in HD patients was 100.0 compared with 10.8 in controls. Thirty-three percent of controls were seronegative to EBV, and none had titers greater than or equal to 1:160. All patients but one were seropositive to EBV, and 8 of 20 had titers greater than or equal to 1:160. Among patients, 13 experienced onset of symptoms in the cold season (October to March) and 8 in the hot season (April to September). Onset during the cold season was usually abrupt with acute symptoms, Stage III to IV, involving the mediastinum and neck. Onset during the hot season was insidious, Stage I to II, with the affected area frequently located below the diaphragm. It is suggested that children of Arab and African-Asian Jewish origin with high serum titers to EBV are at increased risk for HD and for seasonal onset-associated clinical presentation.