title: Prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma patients.
abstract: BACKGROUND
  The prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma (HL) is still controversial. In this work we sought to examine the prognostic differences between EBV-positive and -negative HL through a series of 131 cases from Tunisia.
  
  
  METHODS
  The status of EBV was assessed by EBV-encoded RNA (EBER) in situ hybridization. Results were correlated to patients' characteristics and outcome.
  
  
  RESULTS
  EBV was detected in the malignant cells in 62 of 131 HL cases (47.3%). EBV-positive HL was associated with extreme age classes (≤15 and > 45 years; p = 0.0001), male gender (p = 0.008), mixed cellularity histologic subtype (p = 0.03), and inversely with leukocytosis (white blood cells ≥15000/mm3) (p = 0.004) and bulky mediastinum (mediastinal-thoracic ratio≥ 0.35) (p = 0.0001). On analysis of all patients, no significant difference between survival rates was found between EBV-positive and EBV-negative HL. In contrast, subgroups analysis revealed a negative effect of EBV infection in terms of overall survival in patients with Ann Arbor stages I/II (p = 0.03) and nodular sclerosis HL subgroup (p = 0.01), and in terms of event free survival in patients with mediastinal-thoracic ratio less than 0.35 (p = 0.03).
  
  
  CONCLUSIONS
  These results suggest that EBV infection affects the survival of particular subgroups of HL, especially those with early-stage of the disease.
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
authors.forename: Ben Dhiab
authors.initials: BD
authors.lastname: Myriam
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
authors.forename: Ziadi
authors.initials: Z
authors.lastname: Sonia
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
authors.forename: Saad
authors.initials: S
authors.lastname: Hanene
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
authors.forename: Louhichi
authors.initials: L
authors.lastname: Teheni
authors.affiliation: Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia. Electronic address: m_trimech@yahoo.fr.
authors.forename: Trimeche
authors.initials: T
authors.lastname: Mounir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000473:pathology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000821:virology*; D006801:Humans; D017403:In Situ Hybridization / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics; D014416:Tunisia; D014763:Viral Matrix Proteins / Q000235:genetics; D055815:Young Adult
chemical_list: D012367:RNA, Viral; D014763:Viral Matrix Proteins
keywords: Epstein–Barr virus; Hodgkin lymphoma; Prognostic