title: Atypical prediagnosis Epstein-Barr virus serology restricted to EBV-positive Hodgkin lymphoma.
abstract: An altered anti-Epstein-Barr virus (EBV) serologic profile preceding diagnosis is associated with an increased risk of Hodgkin lymphoma. It is unknown whether this atypical pattern predicts Hodgkin lymphoma risk further subdivided by determination of EBV in tumor cells. A nested case-control study of 128 incident Hodgkin lymphoma cases and 368 matched controls from active-duty military personnel with archived serum in the US Department of Defense Serum Repository was conducted to determine whether a panel of anti-EBV antibody titers differed in EBV(+) and EBV(-) Hodgkin lymphoma. Among 40 EBV(+) Hodgkin lymphoma cases and matched controls, statistically significant increased risks were associated with elevated anti-EBV VCA IgG antibody titers (relative risk = 3.1; 95% confidence interval [CI], 1.1-8.7), and an anti-EBNA-1/anti-EBNA-2 antibody ratio ≤ 1.0 versus > 1.0 (relative risk = 4.7; 95% CI, 1.6-13.8). In contrast, no significant associations were found among 88 EBV(-) Hodgkin lymphoma cases relative to their matched controls. In case-case analysis, EBV(+) disease was significantly associated with a low anti-EBNA-1/anti-EBNA-2 antibody ratio. This distinctive serologic response to EBV latent antigens, indicative of immune dysfunction in other clinical settings, is associated with an increased risk of developing EBV(+) but not EBV(-) Hodgkin lymphoma.
authors.affiliation: Department of Epidemiology, Preventive Medicine Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910-7500, USA. lynn.levin@us.army.mil
authors.forename: Lynn I
authors.initials: LI
authors.lastname: Levin
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Richard F
authors.initials: RF
authors.lastname: Ambinder
authors.forename: Evelyne T
authors.initials: ET
authors.lastname: Lennette
authors.forename: Mark V
authors.initials: MV
authors.lastname: Rubertone
authors.forename: Risa B
authors.initials: RB
authors.lastname: Mann
authors.forename: Michael
authors.initials: M
authors.lastname: Borowitz
authors.forename: Edward G
authors.initials: EG
authors.lastname: Weir
authors.forename: Susan L
authors.initials: SL
authors.lastname: Abbondanzo
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mueller
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D016022:Case-Control Studies; D020031:Epstein-Barr Virus Infections / Q000097:blood* / Q000276:immunology / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006689:Hodgkin Disease / Q000097:blood* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral