Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis.
Level 3 - non-randomized controlled study
Longitudinal cohort study of active-duty military personnel
PubMed 35025605 · doi:10.1126/science.abj8222
What was done
Investigators conducted a longitudinal cohort study of more than 10 million young adults on active duty in the US military to test whether Epstein-Barr virus (EBV) infection precedes multiple sclerosis (MS). They evaluated viral serostatus (including EBV and cytomegalovirus) and tracked serum neurofilament light chain levels, a biomarker of neuroaxonal degeneration, in relation to seroconversion and MS diagnosis.
What was found
A total of 955 individuals developed MS during service. MS risk increased 32-fold following EBV infection, whereas infection with other viruses (including cytomegalovirus) showed no increased risk. Serum neurofilament light chain levels increased only after EBV seroconversion.
Why it matters
This study provides compelling longitudinal evidence implicating EBV infection as a primary trigger or leading causal factor in the development of multiple sclerosis.
Limits
The cohort consisted exclusively of active-duty US military personnel, predominantly young and selected for baseline health, which may limit generalizability to other populations. The abstract does not provide exact confidence intervals, control group numbers, or adjustment metrics for unmeasured confounders.
Cited by
- partial Epstein-Barr virus is causally implicated in triggering Hashimoto's thyroiditis and multiple sclerosis.