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Suad Alotaibi, MD; Julia Kennedy, MSc; Raymond Tellier, MD; Derek Stephens, MSc; Brenda Banwell, MD

JAMA. 2004;291:1875-1879.

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 B19, and varicella zoster did not differ between MS patients and controls.

Conclusion  These results suggest an association between EBV infection and pediatric MS.

Author Affiliations: Department of Pediatrics (Neurology), Al-Sabah Hospital, Shuwaikh, Kuwait (Dr Alotaibi); and Paediatric Laboratory Medicine (Dr Tellier), Department of Paediatrics (Neurology) (Dr Banwell), Brain & Behavior (Ms Kennedy), Population Health Sciences (Mr Stephens), The Hospital for Sick Children, University of Toronto, Toronto, Ontario.

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