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Epstein-Barr virus, cytomegalovirus, and multiple sclerosis susceptibility: A multiethnic study

Langer-Gould, Annette; Wu, Jun; Lucas, Robyn; Smith, Jessica; Gonzales, Edlin; Amezcua, Lilyana; Haraszti, Samantha; Chen, Lie H; Quach, Hong; James, Judith; Barcellos, Lisa F; Xiang, Anny

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Objective: To determine whether Epstein-Barr virus (EBV) or cytomegalovirus (CMV) seropositivity is associated with multiple sclerosis (MS) in blacks and Hispanics and to what extent measures of the hygiene hypothesis or breastfeeding could explain these findings. EBV and CMV have been associated with MS risk in whites, and the timing and frequency of both viruses vary by factors implicated in the hygiene hypothesis. Methods: Incident cases of MS or its precursor, clinically isolated...[Show more]

dc.contributor.authorLanger-Gould, Annette
dc.contributor.authorWu, Jun
dc.contributor.authorLucas, Robyn
dc.contributor.authorSmith, Jessica
dc.contributor.authorGonzales, Edlin
dc.contributor.authorAmezcua, Lilyana
dc.contributor.authorHaraszti, Samantha
dc.contributor.authorChen, Lie H
dc.contributor.authorQuach, Hong
dc.contributor.authorJames, Judith
dc.contributor.authorBarcellos, Lisa F
dc.contributor.authorXiang, Anny
dc.date.accessioned2019-04-14T11:50:32Z
dc.identifier.issn0028-3878
dc.identifier.urihttp://hdl.handle.net/1885/159626
dc.description.abstractObjective: To determine whether Epstein-Barr virus (EBV) or cytomegalovirus (CMV) seropositivity is associated with multiple sclerosis (MS) in blacks and Hispanics and to what extent measures of the hygiene hypothesis or breastfeeding could explain these findings. EBV and CMV have been associated with MS risk in whites, and the timing and frequency of both viruses vary by factors implicated in the hygiene hypothesis. Methods: Incident cases of MS or its precursor, clinically isolated syndrome (CIS), and matched controls (blacks, 111 cases/128 controls; Hispanics, 173/187; whites, 235/256) were recruited from the membership of Kaiser Permanente Southern California. Logistic regression models accounted for HLA-DRB1*1501 status, smoking, socioeconomic status, age, sex, genetic ancestry, and country of birth. Results: Epstein-Barr nuclear antigen-1 (EBNA-1) seropositivity was independently associated with an increased odds of MS/CIS in all 3 racial/ethnic groups (p < 0.001 for blacks and whites, p = 0.02 for Hispanics). In contrast, CMV seropositivity was associated with a lower risk of MS/CIS in Hispanics (p = 0.004) but not in blacks (p = 0.95) or whites (p = 0.96). Being born in a low/middle-income country was associated with a lower risk of MS in Hispanics (p = 0.02) but not after accounting for EBNA-1 seropositivity. Accounting for breastfeeding did not diminish the association between CMV and MS in Hispanics. Conclusions: The consistency of EBNA-1 seropositivity with MS across racial/ethnic groups and between studies points to a strong biological link between EBV infection and MS risk. The association between past CMV infection and MS risk supports the broader hygiene hypothesis, but the inconsistency of this association across racial/ethnic groups implies noncausal associations.
dc.description.sponsorshipThis research was supported by the National Institute of Neurologic Disorders and Stroke (NINDS; 1R01NS075308; principal investigator: Langer-Gould).
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherLippincott Williams & Wilkins
dc.sourceNeurology
dc.titleEpstein-Barr virus, cytomegalovirus, and multiple sclerosis susceptibility: A multiethnic study
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume89
dc.date.issued2017
local.identifier.absfor111711 - Health Information Systems (incl. Surveillance)
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationu4351680xPUB238
local.type.statusPublished Version
local.contributor.affiliationLanger-Gould, Annette, Permanente Southern California
local.contributor.affiliationWu, Jun, Kaiser Permanente Southern California
local.contributor.affiliationLucas, Robyn, College of Health and Medicine, ANU
local.contributor.affiliationSmith, Jessica, Research & Evaluation, Kaiser Permanente Southern California
local.contributor.affiliationGonzales, Edlin, Research & Evaluation, Kaiser Permanente Southern California
local.contributor.affiliationAmezcua, Lilyana, Neurology, USC Los Angeles CA United States
local.contributor.affiliationHaraszti, Samantha , Philadelphia College of Osteopathic Medicine Philadelphia
local.contributor.affiliationChen, Lie H, Department of Research & Evaluation, Kaiser Permanente Southern California
local.contributor.affiliationQuach, Hong, University of California Berkeley Berkeley CA
local.contributor.affiliationJames , Judith, Oklahoma Medical Research Foundation Oklahoma City
local.contributor.affiliationBarcellos, Lisa F , School of Public Health University of California
local.contributor.affiliationXiang, Anny, Research & Evaluation, Kaiser Permanente Southern California
local.description.embargo2040-01-01
local.bibliographicCitation.issue13
local.bibliographicCitation.startpage1330
local.bibliographicCitation.lastpage1337
local.identifier.doi10.1212/WNL.0000000000004412
local.identifier.absseo920111 - Nervous System and Disorders
dc.date.updated2019-03-12T07:27:21Z
local.identifier.scopusID2-s2.0-85030612587
local.identifier.thomsonID000412594100013
dc.provenanceJournal: Neurology (ISSN: 0028-3878, ESSN: 1526-632X) RoMEO: This is a RoMEO white journal Paid OA: A paid open access option is available for this journal. Author's Pre-print: cross author cannot archive pre-print (ie pre-refereeing) Author's Post-print: cross author cannot archive post-print (ie final draft post-refereeing) Publisher's Version/PDF: grey tick subject to Restrictions below, author can archive publisher's version/PDF
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