title: Heterogeneity of risk factors and antibody profiles in epstein-barr virus genome-positive and -negative hodgkin lymphoma.
abstract: BACKGROUND
  Hodgkin lymphoma (HL) tumors that contain the Epstein-Barr virus (EBV) genome may differ etiologically from EBV-negative HL tumors.
  
  
  METHODS
  A case-case study examining heterogeneity of risk factors between disease subgroups compared personal characteristics and EBV antibodies between 95 EBV-positive and 303 EBV-negative patients with HL.
  
  
  RESULTS
  We confirmed previous associations of EBV-positive HL with older age, male sex, and mixed-cellularity (MC) histological subtypes. EBV-positive patients were less educated and more likely to have smoked cigarettes and had more prevalent and higher EBV antibody titers, compared with EBV-negative patients. After adjustment for all independent risk factors, those most strongly associated with EBV-positive HL were histological subtypes (odds ratio [OR] for MC vs. nodular sclerosis histology, 3.2; 95% confidence interval [CI], 1.4-7.2), elevated anti-viral capsid antigen level (OR, 3.1; 95% CI, 1.6-6.0), and less education (OR, 0.7; 95% CI, 0.5-1.0). Cigarette smoking and a low anti-Epstein-Barr nuclear protein (EBNA) 1 : anti-EBNA-2 ratio were also marginally associated with EBV-positive HL.
  
  
  CONCLUSIONS
  EBV-positive HL is more common among individuals who have markers of diminished cellular immunity and an abnormal EBV antibody response. EBV appears to participate in the etiology of EBV-positive HL but may not be involved in EBV-negative HL.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA. echang@jhsph.harvard.edu.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Tongzhang
authors.initials: T
authors.lastname: Zheng
authors.forename: Evelyne T
authors.initials: ET
authors.lastname: Lennette
authors.forename: Edward G
authors.initials: EG
authors.lastname: Weir
authors.forename: Michael
authors.initials: M
authors.lastname: Borowitz
authors.forename: Risa B
authors.initials: RB
authors.lastname: Mann
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mueller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000821:virology*; D005260:Female; D016679:Genome, Viral; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D006689:Hodgkin Disease / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000914:Antibodies, Viral