Infectious mononucleosis and risk for multiple sclerosis: a meta-analysis.
OBJECTIVE
To characterize the association between infectious mononucleosis (IM), a frequent clinical manifestation of primary Epstein-Barr virus infection after childhood, and the risk for multiple sclerosis (MS).


METHODS
We conducted a systematic review and meta-analysis of case-control and cohort studies of IM and MS.


RESULTS
The combined relative risk of MS after IM from 14 studies was 2.3 (95% confidence interval, 1.7-3.0; p < 10(-8)). Potential sources of heterogeneity (ie, study design, MS definition, and latitude) barely influenced our results.


CONCLUSIONS
We conclude that Epstein-Barr virus infection manifesting as IM in adolescents and young adults is a risk factor for MS.
Thacker
Evan L
EL
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. ethacker@hsph.harvard.edu
Mirzaei
Fariba
F
Ascherio
Alberto
A
D000293:Adolescent; D000328:Adult; D002648:Child; D016001:Confidence Intervals; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology*; D016017:Odds Ratio; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors