This Article Full Text (OnlineFirst PDF) All Versions of this Article: 1352458508100037v1 15/4/431    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Nielsen, T. Articles by Hjalgrim, H Search for Related Content PubMed PubMed Citation Articles by Nielsen, T. Articles by Hjalgrim, H Pubmed/NCBI databases Gene GEO Profiles HomoloGene UniGene Medline Plus Health Information Infectious Mononucleosis Multiple Sclerosis Social Bookmarking                         What's this?

Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis

¹ Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
² Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
³ Department of Clinical Immunology, Aalborg Hospital, Aalborg, Denmark
⁴ Danish Multiple Sclerosis Research Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
⁵ Department of Clinical Immunology, Skejby Hospital, Aarhus, Denmark
⁶ National Institute of Public Health, Copenhagen, Denmark; Department of Neurology, Aalborg Hospital, Aalborg, Denmark

^* To whom correspondence should be addressed.

	Abstract

Background

Both human leukocyte antigen (HLA)-DRB1*15 and Epstein-Barr virus infection presenting as infectious mononucleosis (IM) are recognized as risk factors for multiple sclerosis (MS). However, their combined effect and possible interaction on MS risk is not known.

Objective

To assess the association between HLA-DRB1*15 and risk of MS in persons with and without IM.

Methods

We compared the prevalence of DRB1*15 in MS patients with (n = 76) and without (n = 1,836) IM with the corresponding distributions in blood donors with (n = 62) and without (n = 484) IM histories. This allowed us to estimate the relative risk of MS associated with DRB1*15 in the presence and absence, respectively, of previous IM. We then estimated the interaction between DRB1*15 and IM as the ratio of the two individual odds ratios.

Results

In IM-naïve individuals, DRB1*15 carried a 2.4-fold (95% confidence interval [CI], 2.0–3.0) increased MS risk. In contrast, among persons with IM history, DRB1*15 was associated with a 7.0-fold (95% CI, 3.3–15.4) increased MS risk. Thus, the MS risk conferred by HLA-DRB1*15 was 2.9 (95% CI, 1.3–6.5)-fold stronger in the presence than in the absence of IM. Combined with previous results, this result indicates that DRB1*15-positive persons with a history of IM may be at a 10.0-fold (95% CI, 6.0–17.9) increased risk of MS compared with persons who are DRB1*15 and IM-naïve.

Conclusion

DRB1*15 and IM may act in synergy causing MS.

Key Words: epidemiology, HLA-DRB1*15, immunology, infectious mononucleosis, multiple sclerosis

First published on January 19, 2009, doi:10.1177/1352458508100037

Multiple Sclerosis 2009;15:431.

A more recent version of this article appeared on April 1, 2009


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?