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

Authors

  • Evan L. Thacker SM,

    Corresponding author
    1. Department of Nutrition, Harvard School of Public Health, Boston, MA
    • Harvard School of Public Health, Department of Nutrition, 655 Huntington Avenue, Boston, MA 02115
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    • E.L.T. and F.M. contributed equally to this study.

  • Fariba Mirzaei MD, MPH,

    1. Department of Nutrition, Harvard School of Public Health, Boston, MA
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA
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    • E.L.T. and F.M. contributed equally to this study.

  • Alberto Ascherio MD, DrPH

    1. Department of Nutrition, Harvard School of Public Health, Boston, MA
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA
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Abstract

Objective

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).

Methods

We conducted a systematic review and meta-analysis of case–control and cohort studies of IM and MS.

Results

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.

Interpretation

We conclude that Epstein–Barr virus infection manifesting as IM in adolescents and young adults is a risk factor for MS. Ann Neurol 2006; 59:499–503

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