Epstein-Barr virus and risk of non-Hodgkin lymphoma in the cancer prevention study-II and a meta-analysis of serologic studies.
Epstein-Barr virus (EBV) causes rare, malignant lymphomas. The role of EBV in other non-Hodgkin lymphomas (NHLs) remains unclear, but mildly reduced immune function could lead to reactivation of EBV and subsequent NHL. We examined the association between prospectively-collected plasma EBV antibodies and NHL risk in the Cancer Prevention Study-II (CPS-II) Nutrition Cohort and conducted a meta-analysis of our and published results. The CPS-II study included 225 NHL cases and 2:1 matched controls. No associations were observed between EBV serostatus or antibody levels and risk of NHL overall. However, when including only the three most common types of NHL (diffuse large B-cell lymphoma, follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma), high compared to low early antigen (EA-D) diffuse and BZLF1-encoded replication activator antibodies were associated with approximately 60% higher risk of NHL. Odds ratios (ORs) for EBV nuclear antigen-1 and viral capsid antigen (VCA)-p18 were elevated but not statistically significant. In the meta-analysis, both EA (summary OR = 1.52, 95% confidence interval (CI): 1.16-2.00) and VCA (summary OR = 1.20, 95% CI: 1.00-1.44) were positively associated with NHL risk. These results suggest EBV may be associated with a wider spectrum of NHL subtypes, but further study is needed to confirm and fully understand these associations.
Epidemiology Research Program, American Cancer Society, Atlanta, GA.
Lauren R
LR
Teras
Dana E
DE
Rollison
Michael
M
Pawlita
Angelika
A
Michel
Johannes
J
Brozy
Silvia
S
de Sanjose
Jennifer L
JL
Blase
Susan M
SM
Gapstur
D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology; D016022:Case-Control Studies; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000276:immunology / Q000517:prevention & control / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000276:immunology / Q000517:prevention & control / Q000821:virology*; D012306:Risk
D000914:Antibodies, Viral; D000956:Antigens, Viral
Epstein-Barr virus; multiplex serology; non-Hodgkin lymphoma; prospective study