Epstein-Barr virus in pediatric multiple sclerosis.

Context Infection with common viruses, particularly Epstein-Barr virus (EBV), has been postulated to contribute to the pathobiology of multiple sclerosis (MS). Detailed virological studies in pediatric MS have not been previously reported. Objective To evaluate whether children with MS are more likely to be seropositive for EBV or other common viruses than their healthy age-matched peers. Design, Setting, and Patients Case-control study of viral samples collected from March 1994 to February 2003 from 30 pediatric MS patients, 90 emergency department controls matched 3:1 with the MS patients by year of birth, and 53 healthy control children. Main Outcome Measures Archived serum samples were analyzed for the presence of IgG antibodies directed against EBV viral capsid antigens, nuclear antigens, and early antigens, cytomegalovirus, parvovirus B19, herpes simplex virus, and varicella zoster. Results Serological evidence for remote EBV infection was present in 83% of pediatric MS patients compared with 42% of emergency department and healthy controls (P<.001). Five pediatric MS patients were negative for all 3 EBV antigens. Pediatric MS patients were less likely than controls to have been exposed to herpes simplex virus (P=.003), while seropositivity for cytomegalovirus, parvovirus 1319, and varicella zoster did not differ between MS patients and controls. Conclusion These results suggest an association between EBV infection and pediatric MS.