title: Prevalence and prognostic significance of Epstein-Barr virus infection in classical Hodgkin's lymphoma: a meta-analysis.
abstract: OBJECTIVE
  The prevalence and prognostic significance of Epstein-Barr virus (EBV) infection in classical Hodgkin's lymphomas (cHLs) remain elusive. To examine the epidemiological and prognostic differences between EBV-positive and -negative cHLs, we conducted a meta-analysis of 119 published studies including 13,045 cases.
  
  
  METHODS
  We pooled the results of relevant published studies identified using the PubMed and Embase. The effect sizes of outcome parameters were calculated by prevalence, odds ratio (OR), or hazard ratio using a random-effects model.
  
  
  RESULTS
  The pooled prevalence of EBV infection in cHL was 47.9%, which was significantly higher in Africa and Central and South America than other regions. EBV-positive cHL showed higher incidence in children than in adults (69.7 vs. 41.1%). EBV-positive cHL was significantly related to male (OR = 1.8, 95% CI: 1.510-2.038; p <0.001), mixed cellularity subtype (OR = 3.8, 95% CI: 3.243-4.451; p <0.001), and advanced clinical stages (OR = 1.2, 95% CI: 1.072-1.369; p = 0.002). However, the presence of EBV in cHL was not associated with overall or event-free survival.
  
  
  CONCLUSIONS
  The prevalence of EBV differs according to age, sex, region, histologic subtype, and clinical stage of cHL. However, the presence of EBV has little effects on cHL patient's survival.
authors.affiliation: Department of Pathology, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Ju-Han
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pathology, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Younghye
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Pathology, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Jung-Woo
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Pathology, Korea University Ansan Hospital, Ansan, Republic of Korea. Electronic address: apysk@korea.ac.kr.
authors.forename: Young-Sik
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006689:Hodgkin Disease / Q000401:mortality / Q000821:virology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
keywords: Epstein-Barr virus; Hodgkin's lymphoma; Meta-analysis