Issue: October 2017
September 13, 2017
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Epstein-Barr virus increases risk for MS across multiple races

Issue: October 2017
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Black, Hispanic and white patients who have had infectious mononucleosis, caused by Esptein-Barr virus, were significantly more likely to develop multiple sclerosis, according to recent study findings.

“Previous studies that have found a link between mononucleosis and MS have looked primarily at white populations, so for our study, we examined whether there was a similar link for other racial groups as well,” Annette Langer-Gould, MD, PhD, adjunct clinical assistant professor at Kaiser Permanente Southern California in Pasadena and member of the American Academy of Neurology, said in a press release. “Indeed, we did find a strong biological link for all three racial groups.”

Langer-Gould and colleagues examined data on 1,090 black (n = 239), Hispanic (n = 360), and white (n = 491) participants with and without MS or clinically isolated syndrome, an early stage of MS. The participants were screened for Epstein-Barr virus antibodies and self-reported whether they ever had mononucleosis.

Overall, 10.8% of black participants with MS had infectious mononucleosis (IM) in the past vs. 3.1% of controls (P = .02); 7.5% of Hispanic participants with MS had IM vs. 1.6% of controls (P = .01); and 20.4% of white participants with MS had IM vs. 11.7% of controls (P = .01).

The risk for MS was 4.43 (95% CI, 1.33-14.77) times higher in blacks, 3.66 (95% CI, 0.98-13.66) times higher in Hispanics, and 2.24 (95% CI, 1.32-3.79) times higher in whites who had IM vs. those who did not have the infection, according to the researchers. The association was independent of other MS risk factors, including gender, age, smoking and genetic ancestry.

“While many people had Epstein-Barr virus antibodies in their blood, we found among all three groups, people who also developed mono in their teen years or later had a greater risk for MS,” Langer-Gould said. “This implies that delaying Epstein-Barr virus infection into adolescence or adulthood may be a critical risk factor for MS.”

The researchers concluded that the consistency of their findings across the study population strengthens the link between IM and MS.

“Studies like ours that include participants from multiple racial groups can be a strong tool to test for biological risk factors, especially when the frequency of exposures to biological factors like Epstein-Barr virus and mononucleosis differ between groups,” Langer-Gould said. “If the findings were not the same across all groups, it would be less likely that a link would be biological.” – by Stephanie Viguers

Disclosure: Langer-Gould reports receiving grant support from the NIH, National Multiple Sclerosis Society, National Institute of Neurological Disorders and Stroke, and Patient-Centered Outcomes Research Institute. She also participated in phase 3 trials sponsored by Biogen Idec and Hoffman-Roche. Please see the study for all other authors’ relevant financial disclosures.