title: Age-specific prevalence of Epstein-Barr virus infection among Minnesota children: effects of race/ethnicity and family environment.
abstract: BACKGROUND
  Primary Epstein-Barr virus (EBV) infection affects the host differently according to when in life it is acquired. Understanding risk factors for infection could be important for disease prevention, and the age-specific prevalence of infection must be known to optimize use of a prophylactic vaccine.
  
  
  METHODS
  Children 18 months to 19.9 years of age who had blood drawn for medical indications during an outpatient visit were eligible. Sera were tested for immunoglobulin G antibodies against EBV viral capsid antigen by enzyme immunoassay. Family demographic and socioeconomic data were obtained via scripted telephone questionnaires.
  
  
  RESULTS
  Consent was given for 876 of 914 (96%) subjects approached. Sera were available for 782 of 876 (89%) subjects and demographic/socioeconomic data obtained for 705 (90%) of them. Antibody prevalence, adjusted for age and sex, was as follows: non-Hispanic blacks, 74%; Asians, 62%, multiracial children, 54%; Hispanics, 50%; and non-Hispanic whites, 26%. The pattern of increases in antibody prevalence with age differed significantly by race/ethnicity, and was most divergent in the 2 youngest age groups. Adjusted EBV antibody prevalence decreased with greater household education among non-Hispanic whites, but was not associated with any other socioeconomic factor. In 42 of 51 (82%) families with >1 child in the study, the siblings' EBV antibody status was concordant (bootstrap P < .001).
  
  
  CONCLUSIONS
  Racial/ethnic differences in EBV antibody prevalence and concordance of antibody status among siblings prompt us to speculate that both genetics and family environment contribute to acquisition of EBV infection. The ideal age to give a prophylactic vaccine may differ according to race/ethnicity.
authors.affiliation: Department of Pediatrics, HealthPartners, Bloomington.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Condon
authors.affiliation: Department of Pediatrics, HealthPartners, Bloomington.
authors.forename: Laurel E
authors.initials: LE
authors.lastname: Cederberg
authors.affiliation: Department of Pediatrics, HealthPartners, Bloomington.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Rabinovitch
authors.affiliation: Department of Pediatrics, HealthPartners, Bloomington.
authors.forename: Rhoda V
authors.initials: RV
authors.lastname: Liebo
authors.affiliation: Department of Pediatrics, HealthPartners, Bloomington.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Go
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Delaney
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School.
authors.forename: David O
authors.initials: DO
authors.lastname: Schmeling
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota.
authors.forename: William
authors.initials: W
authors.lastname: Thomas
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota Medical School Department of Pediatrics, University of Minnesota Medical School, Minneapolis.
authors.forename: Henry H
authors.initials: HH
authors.lastname: Balfour
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood*; D036022:Capsid Proteins / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology*; D005006:Ethnicity; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D036022:Capsid Proteins; D007074:Immunoglobulin G
keywords: Epstein-Barr virus; age-specific EBV antibody prevalence; epidemiology of EBV infections; genetics; racial/ethnic differences