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To the Editor: A strong association between multiple sclerosis (MS) and Epstein-Barr virus (EBV) seropositivity has been confirmed in prospective studies, supporting the view that past EBV infection may be a prerequisite for the development of MS.¹ However, because about 90% of the general population is also EBV seropositive,² the mechanism by which EBV could be involved in the pathogenesis of MS remains unanswered. The study by Dr Ponsonby and colleagues³ suggests that late EBV infection in particular increases the risk of developing MS, while exposure to EBV early in life may have a marked protective effect.

In addition to the possible explanations for this phenomenon discussed in the article, there is an alternative scenario.⁴ If MS were related to the interaction of EBV with a retrovirus, and the pathogenicity of this retrovirus critically depended on some factor(s) provided by EBV during the acute phase of infection, many features of . . . [Full Text of this Article]

Klemens Ruprecht, MD
klemens.ruprecht@mail.uni-wuerzburg.de
Department of Psychiatry
Julius-Maximilians University
Würzburg, Germany

Hervé Perron, PhD
Research & Development, Immunoassays
bioMérieux
Marcy l’Etoile, France

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