Association of Epstein-Barr virus infection with multiple sclerosis in India.

OBJECTIVES: Epstein-Barr virus (EBV) seroprevalence is high from early childhood in Indian populations, though multiple sclerosis (MS) is uncommon. The present study aims to evaluate the association of EBV infection with MS in Indian patients.

METHOD: In this study 140 MS patients and equal number of matched controls were included. Estimation of serum Immunoglobin G (IgG) for EBV Nuclear antigen 1 (EBNA1), viral capsid antigen (EBV-VCA) and early antigen (EB-EA) were obtained by quantitative enzyme linked immunosorbent assay (ELISA). Patients and controls were genotyped for the human leukocyte antigen (HLA) DRB1*1501 allele.

RESULTS: A modest difference was observed for EBNA1 (p=0.02) and EBV-VCA (p=0.03) titres in MS patients as compared to healthy controls. There was no association between EBNA1 titres and MS. High EBNA1 titre (>99.75U/l) was significantly associated with HLA DRBI*15:01 (OR=4.92. CI=1.07-22.57) status in MS patients but not in healthy controls (OR=1.19, CI=0.53-2.63).

CONCLUSION: Evidence for a strong association with remote EBV infection was lacking in this study of Indian patients with MS. Patients who are carriers of HLA DR15 allele may have high EBNA1 titres. These preliminary results need to be reproduced in an independent and larger dataset.