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Systematic Review and Meta-Analysis of the Sero-Epidemiological Association between Epstein Barr Virus and Multiple Sclerosis

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  • Yahya H Almohmeed
  • Alison Avenell
  • Lorna Aucott
  • Mark A Vickers

Abstract

Background: A role for Epstein Barr virus (EBV) in multiple sclerosis (MS) has been postulated. Previous systematic reviews found higher prevalences of anti-EBV antibodies in MS patients compared to controls, but many studies have since been published, and there is a need to apply more rigorous systematic review methods. Methodology/Principal Findings: We examined the link between EBV and MS by conducting a systematic review and meta-analysis of case-control and cohort studies that examined the prevalence of anti-EBV antibodies in the serum of cases and controls. We searched Medline and Embase databases from 1960 to 2012, with no language restriction. The Mantel-Haenszel odds ratios (OR) for anti-EBV antibodies sero-positivity were calculated, and meta-analysis conducted. Quality assessment was performed using a modified version of the Newcastle Ottawa scale. Thirty-nine studies were included. Quality assessment found most studies reported acceptable selection and comparability of cases and controls. However the majority had poor reporting of ascertainment of exposure. Most studies found a higher sero-prevalence of anti-EBNA IgG and anti-VCA IgG in cases compared to controls. The results for anti-EA IgG were mixed with only half the studies finding a higher sero-prevalence in cases. The meta-analysis showed a significant OR for sero-positivity to anti-EBNA IgG and anti-VCA IgG in MS cases (4.5 [95% confidence interval (CI) 3.3 to 6.6, p

Suggested Citation

  • Yahya H Almohmeed & Alison Avenell & Lorna Aucott & Mark A Vickers, 2013. "Systematic Review and Meta-Analysis of the Sero-Epidemiological Association between Epstein Barr Virus and Multiple Sclerosis," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-15, April.
  • Handle: RePEc:plo:pone00:0061110
    DOI: 10.1371/journal.pone.0061110
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    References listed on IDEAS

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    1. Gisela Kobelt & Jenny Berg & P. Lindgren & J. Kerrigan & N. Russell & R. Nixon, 2006. "Costs and quality of life of multiple sclerosis in the United Kingdom," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(02), pages 96-104, July.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Gisela Kobelt & Jenny Berg & P. Lindgren & J. Kerrigan & N. Russell & R. Nixon, 2006. "Costs and quality of life of multiple sclerosis in the United Kingdom," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(2), pages 96-104, July.
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    1. Alexander J. Mentzer & Nicole Brenner & Naomi Allen & Thomas J. Littlejohns & Amanda Y. Chong & Adrian Cortes & Rachael Almond & Michael Hill & Simon Sheard & Gil McVean & Rory Collins & Adrian V. S. , 2022. "Identification of host–pathogen-disease relationships using a scalable multiplex serology platform in UK Biobank," Nature Communications, Nature, vol. 13(1), pages 1-12, December.

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