Infectious mononucleosis and risk for multiple sclerosis: a meta-analysis

Annals of Neurology
Evan L ThackerA Ascherio

Abstract

To characterize the association between infectious mononucleosis (IM), a frequent clinical manifestation of primary Epstein-Barr virus infection after childhood, and the risk for multiple sclerosis (MS). We conducted a systematic review and meta-analysis of case-control and cohort studies of IM and MS. The combined relative risk of MS after IM from 14 studies was 2.3 (95% confidence interval, 1.7-3.0; p < 10(-8)). Potential sources of heterogeneity (ie, study design, MS definition, and latitude) barely influenced our results. We conclude that Epstein-Barr virus infection manifesting as IM in adolescents and young adults is a risk factor for MS.

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