Although the exact cause of multiple sclerosis remains elusive, repeat studies suggest that infection with Epstein-Barr virus (EBV)  increases a person’s risk of developing MS.

What is EBV?

Epstein-Barr virus (EBV), also known as human herpesvirus 4, is one of the most common human viruses and is found worldwide. It is transmitted through bodily fluids, especially saliva, but also through blood and semen or organ transplant or blood transfusion.

EBV infection is most common in childhood, but many people are infected at some point in their lives. The virus is largely asymptomatic, especially in the young, or difficult to distinguish from a mild cold. In adults, symptoms of Epstein-Barr Virus can range from  fever and fatigue to a sore throat, rash, and an enlarged liver or spleen, all of which are also symptoms of infectious mononucleosis – a contagious disease that is commonly caused by Epstein-Barr Virus in adults.

Research into Epstein-Barr Virus and MS

Research is ongoing into a possible association between EBV and MS, including into the possibility that EBV plays a direct role in MS onset.

In one prospective study, researchers at Harvard reported finding a link between EBV infection and an increased risk of developing MS. Likewise, another study compared blood samples of 222 U.S. military personnel who developed MS with samples with 444 disease-free but age- and sex-matched controls, and found a striking 36-fold higher risk of MS onset in those with high levels of Epstein-Barr Virus antibodies in their blood.  “Serum titers [concentrations] of pre-onset anti-EBNA antibodies are strong, robust markers of MS risk,” these researchers concluded.

case-control study assessed Epstein-Barr Virus in 75 MS patients (compared to an equal number of controls) by testing both groups for immunoglobulin G (IgG) antibodies against a protein associated with EBV infection, called the Epstein-Barr nuclear antigen-1 (EBNA1). Results found significantly higher serum concentrations of EBNA1, a protein associated with Epstein-Barr Virus, in 70 of the MS patients than were found in the MS-free control group.

Growing evidence suggests that Epstein-Barr Virus infection is more common in MS patients than in people without MS, and repeat studies seem to support both a history of mononucleosis and high serum EBV antibody levels as disease risk factors. Further research, especially large-scale studies, is needed to better establish and define the precise role that Epstein-Barr Virus may play in MS.

 

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