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No link found between rheumatoid arthritis and Epstein-Barr virus infection
No association was observed between the seroprevalence of Epstein-Barr virus and the development of rheumatoid arthritis, according to the results of a study.
Researchers used the Ovid search tool to search Medline files published between 1946 and December 2014 and Embase between 1984 and December 2014 for entries with cohort or case-control studies of patients with rheumatoid arthritis (RA) and Epstein-Barr virus (EBV)-related antibodies: viral capsid antibody (VCA), early antigen (EA) and EBV nuclear antigen (EBNA)-1 or EBNA-2.
Twenty-three articles met the authors’ inclusion criteria, all of which were case-control studies with a median sample size of 50 patients with RA and 43 control participants. Diagnostic criteria was not provided in three studies while 20 used American College of Rheumatology (ACR) or American Rheumatology Association criteria. The presence of anti-VCA immunoglobulin G (IgG) was reported in 18 studies with 943 patients with RA and 791 healthy participants. Eight of the 18 studies showed a higher rate of seropositivity in patients with RA, but one study had a significantly lower rate of antibody detection and was excluded for “implausibly low” rates of antibody detection, according to the researchers. Analysis of the data in the remaining articles showed no significant difference in the prevalence of VCA IgG between patients with RA and control groups with an OR of 1.47.
The presence of anti-EBNA-1 antibodies was reported in 12 studies of 737 patients with RA and 791 control participants. In six of the studies, a greater prevalence of seropositivity was shown in patients with RA, but without statistical significance and an OR of 1.05. Statistical significance was also not met in eight studies which reported a higher prevalence of anti-EA antigen.
The quality of the available data was questioned by the researchers.
“Of further concern is the high level of heterogeneity between the ORs of the individual studies, the lack of consistency in matching of cases and controls, and the paucity of reporting of recruitment and laboratory methodology, as seen in the quality assessment,” the authors wrote. “We attempted to control for these factors by analyzing only studies with community controls; however, this limited the overall RA population studied for VCA and EBNA-1 antibodies to seven studies, with the results showing no difference between seropositivity for these two groups.” – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.