Objectives: To assess risk of a first clinical diagnosis of clinically isolated syndrome (CIS) in relation to measures of Epstein-Barr virus (EBV) infection within the context of other known risk factors.
Results: Higher anti-EBV antibody levels and a history of infectious mononucleosis (IM) were associated with increased CIS risk and there was an additive interaction with the main MS susceptibility gene HLA-DRB1*1501. There were additional interactions between high anti-EBNA antibody levels and variants in the HLA-A gene; if yo had both of these factors or your risk of CIS was 20X greater than if you had neither of these factors. EBV viral load was lower at higher serum vitamin D concentrations in controls subjects.
Conclusion: Past infection with EBV, but not current EBV viral load in whole blood, is significantly associated with increased CIS risk. These associations are modified by immune-related gene variants.
Lucas et al. Current and past Epstein-Barr virus infection in risk of initial CNS demyelination. Neurology 2011; Published online before print , doi:
“Yet another study showing an interaction between EBV and the immune function gene associated with increased MS risk. The risk of getting CIS if you have both risk factors is 20x greater than if you don’t. Interesting?”
“This study also hints at an interaction between EBV and vitamin D levels; this is not surprising given the major role vitamin D plays in immune function.”
“Another bit of evidence supporting the need to do large studies to try and bring the MS risk factors together in a prediction study. We are hoping to do this with our PredictMS study.”
“This study also supports the need to be vitamin D replete.”