title: Changing patterns in the Epstein-Barr virus (EBV)and Hodgkin lymphoma association in Tunisia.
abstract: We compared the features of the Epstein-Barr virus (EBV) and Hodgkin lymphoma (HL) association in Tunisia in two periods of time, 1991-2001 (111 cases) and 2002-2012 (122 cases). The investigation of the EBV status by EBER in situ hybridization showed a significant decrease in the prevalence of EBV-positive HL from 69.3 % for the period 1991-2001 to 40.1 % for the 2002-2012 period (p = 0.00001). EBV positivity has decreased in all age groups but was more pronounced among young patients, in the 15-24-year age group (46.1 vs 10.3 %, p = 0.003), in the 25-34-year age group (56.2 vs 25 %, p = 0.04), and among children (88.4 vs 59.2 %, p = 0.01). This decrease in EBV-positive HL over time contrasted with a remarkable increase in EBV-negative HL in young adults aged 15-34 years (51.2 vs 83 %; p = 0.001), especially among women (59.1 vs 91.2 %; p = 0.01). The decrease in EBV-positive HL over time concerns particularly the nodular sclerosis histological subtype (69.2 vs 31.6 %, p = 0.000001). These results indicate that the epidemiology of HL and its association with EBV are changing over time, with a trend toward a Western profile, and point toward the emergence of other environmental causative factors, especially among young women, which remain to be identified.
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse, 4000, Tunisia.
authors.forename: Myriam Ben
authors.initials: MB
authors.lastname: Dhiab
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse, 4000, Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ziadi
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse, 4000, Tunisia.
authors.forename: Hanene
authors.initials: H
authors.lastname: Saad
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse, 4000, Tunisia.
authors.forename: Teheni
authors.initials: T
authors.lastname: Louhichi
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse, 4000, Tunisia. m_trimech@yahoo.fr.
authors.forename: Mounir
authors.initials: M
authors.lastname: Trimeche
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000502:physiology; D006689:Hodgkin Disease / Q000453:epidemiology*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics*; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: Epidemiology; Epstein-Barr virus; Hodgkin lymphoma; Trend; Tunisia