An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis.
BACKGROUND
Multiple sclerosis (MS) appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV) infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM) has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published.


RESULTS
We performed a Medline search to identify articles published since the original meta-analysis investigating MS risk following IM. A total of 18 articles were included in this study, including 19390 MS patients and 16007 controls. We calculated the relative risk of MS following IM using a generic inverse variance with random effects model. This showed that the risk of MS was strongly associated with IM (relative risk (RR) 2.17; 95% confidence interval 1.97-2.39; p<10(-54)).


CONCLUSIONS
Our results establish firmly that a history of infectious mononucleosis significantly increases the risk of multiple sclerosis. Future work should focus on the mechanism of this association and interaction with other risk factors.
Handel
Adam E
AE
Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom.
Williamson
Alexander J
AJ
Disanto
Giulio
G
Handunnetthi
Lahiru
L
Giovannoni
Gavin
G
Ramagopalan
Sreeram V
SV
D015331:Cohort Studies; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications* / Q000821:virology; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors
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