title: Role of sexual behavior in the acquisition of asymptomatic Epstein-Barr virus infection: a longitudinal study.
abstract: BACKGROUND
  The natural history of Epstein-Barr virus (EBV) infection is poorly defined. We report the prevalence and subsequent incidence of EBV infection in a cohort of sexually active young women and explore the social and sexual determinants of incident infections.
  
  
  METHODS
  The study population was drawn from a cohort of young women, who were recruited for a longitudinal study of risk factors for early cervical neoplasia. A case-control analysis, nested within the cohort of 45 women for whom the first EBV sample tested was EBV-negative and who had further follow-up, was undertaken. EBV serostatus was determined in serum with a synthetic peptide-based enzyme-linked immunosorbent assay; EBV DNA was measured in cervical smears with the use of quantitative polymerase chain reaction.
  
  
  RESULTS
  Of 1023 women 15-19 years of age included in this analysis, 978 (95.6%) tested positive for antibodies to EBV in their first serum sample. Of 45 women who tested negative, 22 subsequently acquired an asymptomatic EBV infection; the median time to seroconversion was 25 months (range, 1-60 months), and the median age at seroconversion was 18 years (range, 16-21 years). The risk of seroconversion increased with increasing number of sexual partners [compared with 1 partner, odds ratio (OR) was 1.28 for 2 partners and 2.23 for 3 or more; chiTREND 5.02; df 1; P < 0.05] and was greatest when a new sexual partner had been acquired in the 2 years before seroconversion (OR 4.78; chi 4.62; df 1; P < 0.05). EBV DNA was detected in 9 of 14 women who seroconverted and who also provided cervical samples.
  
  
  CONCLUSIONS
  In susceptible young women, the acquisition of EBV infection is associated with their sexual behavior.
authors.affiliation: Cancer Research UK Institute for Cancer Studies, University of Birmingham.
authors.forename: Ciaran B J
authors.initials: CB
authors.lastname: Woodman
authors.forename: Stuart I
authors.initials: SI
authors.lastname: Collins
authors.forename: Nicol
authors.initials: N
authors.lastname: Vavrusova
authors.forename: Ankit
authors.initials: A
authors.lastname: Rao
authors.forename: Jaap M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Kolar
authors.forename: Angela
authors.initials: A
authors.lastname: Kumari
authors.forename: Paul
authors.initials: P
authors.lastname: Nelson
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Young
authors.forename: Paul G
authors.initials: PG
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000635:transmission* / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral