The elimination of circulating Epstein-Barr virus infected B cells underlies anti-CD20 monoclonal antibody activity in multiple sclerosis: A hypothesis

•The precise mechanism by which anti-CD 20 monoclonal antibodies exert their salutary effect in multiple sclerosis remains uncertain.•There is incontrovertible evidence linking Epstein-Barr virus (EBV) to multiple sclerosis.•We propose that the beneficial effects of anti-CD 20 monoclonal antibodies in multiple sclerosis results from their effect on EBV-infected B cells.