title: Role of early viral infections in development of multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis is a chronic inflammatory, autoimmune, demyelinating, disease but also degeneration of axons, with mainly progressive course, causing greater or lesser degree of disability. In addition to genetic predisposition the environmental factors, with particular importance of early viral infection, have an essential role in the development of MS. These are called long-acting viruses that remain hidden in the body for years by encouraging latent immunological changes in the body, eventually resulting in autoimmune demyelination and the appearance of disease symptoms, which confirms the high titer of antibodies to certain viruses in patients with the MS. To first of all herpes simplex virus, Epstein Barr virus, cytomegalovirus and rubella virus.
  
  
  OBJECTIVE
  Goal of this study is to analyze the incidence of early infection with rubella virus, herpes simplex, cytomegalovirus and Epstein-Barr, in MS patients using titers of IgG and IgM antibodies.
  
  
  METHODS
  The study included patients treated at the Neurology Clinic in Sarajevo, with a diagnosis of multiple sclerosis (newly discovered) in the period January 2009-December 2011. To all patients beside history and neurological examination and tests to confirm the MS (brain MRI, evoked potentials and CSF examination) made serological tests for viruses, HSV, Rubella virus, cytomegalovirus and Ebstain-Barr's virus, with reference to the previous parameters (old) and new viral infection.
  
  
  RESULTS
  In this period there were 118 newly diagnosed multiple sclerosis from which 69.5% (82) female and 30.5% (36) male patients aged 23-56 years. IgG antibodies to herpes simplex virus was positive in 93.2% (110 patients) (72 F and 38 M and IgM only in 0.84% (1 patient). Ig G in Cytomegalovirus was positive in 86.44% (102 subjects, 71 females and 31 males), while IgM was negative in whole sample. IgG Rubella virus was positive in 61.01% (72 patients, 52 F and 20 M) and IgM was negative in all, while IgG in Ebstain-Barr's virus was positive in 83% (98 patients).
  
  
  CONCLUSIONS
  Early infection by herpes simplex virus, cytomegalovirus, Epstein-Barr and Rubella is present in patients with multiple sclerosis in a significant number so the conclusions is the fact that in the development of multiple sclerosis an important role early exposure to these viruses. Key words: early viral infection, multiple sclerosis.
authors.affiliation: Neurology Clinic, Clinical Center of University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Jasminka
authors.initials: J
authors.lastname: Djelilovic-Vranic
authors.forename: Azra
authors.initials: A
authors.lastname: Alajbegovic
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006561:Herpes Simplex / Q000150:complications; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000821:virology*; D012409:Rubella / Q000150:complications; D014777:Virus Diseases / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult