Neuropediatrics 2005; 36 - P121
DOI: 10.1055/s-2005-868106

Association of Epstein-Barr virus (EBV) infection with multiple sclerosis in pediatric patients

HJ Wagner 1, D Pohl 2, S Köllmann 1, P Bucsky 1, J Sperner 1, F Hanefeld 2
  • 1Department of Pediatrics, Lübeck
  • 2Department of Neuropediatrics, Göttingen

Objective: Epidemiological studies suggest an association between Epstein-Barr virus (EBV) infections and risk of multiple sclerosis (MS)in adults. As children and adolescents had limited contacts to infectious agents in previous life, individuals with early-onset MS are optimal candidates for examining microorganism as co-factors for the development of MS. Aim of our study was to determine the EBV-serostatus in children and adolescents with early-onset MS in comparison to the serostatus of other herpesviruses.

Methods: 73 pediatric patients with early-onset MS (median of age 15 years, range 8–23 years) were enrolled in this cross-sectional study. Blood samples were taken at diagnosis of MS and were analysed in comparison to 77 age- and sex matched controls. Six different EBV-seromarker (anti-EBNA1-IgG, anti-VCA-IgG, anti-EA-IgG, -IgM and -IgA antibodies) as well as IgG antibodies against herpesvirus 1 and 2 (HSV), varicella-zoster-virus (VZV) and human cytomegalovirus (hCMV) were examined.

Results: All pediatric MS patients were EBV-seropositive as indicated by a positivity for VCA-IgG (73/73, 100%). This result was confirmed by anti-EBNA1-IgG, a late seroconversion marker, for which all but one MS patients were positive (72/73 patients or 98.6% anti-EBNA1-IgG-positive). In contrast, healthy children and adolescents were EBV-seropositve in only 71.4% (55/77 controls anti-VCA-IgG and 54/77 anti-EBNA1-IgG-positive) (Chi-square=23.2; p<0.001 for VCA-IgG or Chi-square=21,3; p<0.001 for anti-EBNA1-IgG). No primary EBV-infections were found in MS patients. Anti-VCA-IgG and anti-EBNA1-IgG antibody titers were significantly higher in the group of pediatric MS patients compared with healthy controls (p<0.01, respectively). No differences in the prevalence or titers for anti-HSV-IgG, -VZV-IgG or -hCMV-IgG antibodies were found between both groups.

Conclusions: The 100% EBV-seropositivity of children and adolescents with early onset-MS and the lack of primary infections suggest that MS patients are infected with EBV before the development of MS.