Viruses and Hodgkin's disease

Hodgkin's disease (HD) is a heterogeneous condition with distinct histological and epidemiological subgroups. Recent data provide evidence that the Epstein-Barr virus (EBV) is associated with a significant proportion of cases. Clonal EBV genomes have been detected in affected tissues and EBV has been localised to RS cells. The significance of these findings is reinforced by the detection of the EBV latent gene product LMP-1, which has known transforming potential, within RS cells in EBV-associated cases. The age distribution of EBV-associated cases is non-random. Paediatric cases, particularly those aged < 10 years, are likely to be EBV-associated as are older adult cases. In contrast, a smaller proportion of young adult cases is EBV-associated, and nodular sclerosis HD cases within this age group are positive infrequently. The results of our studies provide support for the hypothesis that HD has multiple aetiologies but do not support the polio model. The epidemiological evidence suggesting that HD may have an infectious aetiology is strongest for the young adult age group. EBV was suggested as a candidate virus however it is in these cases that there is least evidence for involvement of EBV. It would seem plausible that another virus, possibly another common childhood infectious agent, is responsible for the incidence peak seen in this age group in developed countries.