title: The effect of Epstein-Barr virus status on outcome in age- and sex-defined subgroups of patients with advanced Hodgkin's disease.
abstract: BACKGROUND
  Conflicting data on the effect of the Epstein-Barr virus (EBV) on outcome in Hodgkin's disease (HD) might be due to the heterogeneous nature of this disease. In this study we have investigated whether the effect of EBV status on outcome is different between aetiologically defined age groups (15-34, 35-44, 45+ years) and also between males and females.
  
  
  METHODS
  Paraffin-embedded sections from 273 patients with advanced HD from two related clinical trials were analysed for the presence of EBV using in situ hybridisation.
  
  
  RESULTS
  EBV was detected in 78 (29%) of cases. For all patients, after a median follow-up of 5 years, there were no significant differences in survival by EBV status although there was a trend towards longer failure-free survival times for EBV-positive patients. Multivariate analyses suggested that EBV and sex, when in combination, were prognostic factors for failure-free survival (P = 0.06 for both). For subgroups, the effect of EBV on failure-free survival was significant for males and 15-34 years age group (P = 0.05 and P = 0.03, respectively).
  
  
  CONCLUSIONS
  This study suggests that with a median follow-up of 5 years, EBV status does not affect survival but being EBV-positive may be beneficial in terms of failure-free survival, particularly for males and younger adults.
authors.affiliation: School of Health Sciences, University of Wolverhampton, Wolverhampton, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Flavell
authors.forename: L J
authors.initials: LJ
authors.lastname: Billingham
authors.forename: J P
authors.initials: JP
authors.lastname: Biddulph
authors.forename: L
authors.initials: L
authors.lastname: Gray
authors.forename: J R
authors.initials: JR
authors.lastname: Flavell
authors.forename: C M
authors.initials: CM
authors.lastname: Constandinou
authors.forename: L S
authors.initials: LS
authors.lastname: Young
authors.forename: P G
authors.initials: PG
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D004854:Herpesvirus 4, Human / Q000472:pathogenicity*; D006689:Hodgkin Disease / Q000473:pathology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors