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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/453| Epidemiology of Epstein-Barr Virus infection and Infectious Mononucleosis in the United Kingdom | |
| Ashvin Kuri Nicola Vickaryous Julia Pakpoor Jaap Middeldorp Gavin Giovannoni Ruth Dobson Benjamin Meir Jacobs | |
| Novel Coronavirus | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| 10.1101/2020.01.21.20018317 | |
| Background: Epstein Barr Virus (EBV) is a ubiquitous gamma-herpesvirus with which ~95% of the healthy population is infected. EBV infection has been implicated in a range of haematological malignancies and autoimmune diseases. Delayed primary EBV infection increases the risk of subsequent complications. Over recent decades, the age of primary EBV infection has become later, largely due to improved sanitation and living conditions. Methods and findings: First, we conducted a seroepidemiological survey of healthy volunteers between 0 and 25 years old to assess prevalence of detectable anti EBV antibodies. 1982 of 2325 individuals (85.3%) were EBV seropositive. EBV seropositivity increased monotonically with age, and increased more among females than males during adolescence (ages 10 to 15). Second, we conducted a retrospective review of Hospital Episode Statistics to determine changes in Infectious Mononucleosis (IM) incidence over time. Between 2002 and 2013, the incidence of IM (derived from hospital admissions data) increased. We then conducted a large case-control study of 6306 prevalent IM cases and 1,009,971 unmatched controls extracted from an East London GP database to determine exposures associated with IM. Exposures associated with lower risk of IM were elevated BMI (Overweight OR 0.80 [0.75 to 0.86], obese OR 0.63 [0.57 to 0.70]), non-white ethnicity (Black OR 0.21 [0.18 to 0.23], Asian OR 0.14 [0.13 to 0.16], Other ethnicity OR 0.22 [0.19 to 0.25]), and a history of smoking (OR 0.87 [0.83 to 0.92]), whereas affluence was associated with a higher risk of IM (per increase in IMD decile OR 1.15 [1.13 to 1.17]. Finally, we used ELISA to determine antibody responses to common pathogens and vaccine antigens among EBV seronegative individuals. EBV seronegative donors did not display diminished serum antibody responses to pertussis, rubella, or varicella compared to EBV seropositive donors. Conclusions: In this study we make several important observations on the epidemiology of EBV infection in the UK. We find that overall EBV seroprevalence in the UK appears to have increased, and that the sharp increase in EBV seropositivity takes places earlier among females than males. We find that the incidence of IM requiring hospitalisation is increasing. We find that exposures associated with prevalent IM in a diverse population include white ethnicity, affluence, lower BMI, and never-smoking, and these exposures interact with each other. Lastly, we provide pilot evidence suggesting that antibody responses to vaccine and encountered pathogens do not seem to be diminished among EBV seronegative individuals, which is a theoretical counter-argument to developing EBV vaccines. Our findings could help to inform vaccine study designs in efforts to prevent IM and late complications of EBV infection, such as Multiple Sclerosis. ### Competing Interest Statement RD: Honoraria for speaking or other educational activities: Biogen, Merck, Teva Support to attend educational meeting: Sanofi Honoraria for advisory board: Merck, Biogen Research support: Biogen, Merck, Celgene JM is CEO at Cyto-Barr BV. GG: I have received research grant support from Bayer-Schering Healthcare, Biogen-Idec, GW Pharma, Merck, Merck-Serono, Merz, Novartis, Teva and Sanofi-Aventis. I have also received personal compensation for participating on Advisory Boards in relation to clinical trial design, trial steering committees and data and safety monitoring committees from: Abbvie, Bayer-Schering Healthcare, Biogen-Idec, Canbex, Eisai, Elan, Fiveprime, Genzyme, Genentech, GSK, Ironwood, Merck, Merck-Serono, Novartis, Pfizer, Roche, Sanofi-Aventis, Synthon BV, Teva, UCB Pharma and Vertex Pharmaceuticals. JP: Served on an advisory board for Merck Serono ### Funding Statement We are grateful to Barts Charity for supporting this work, to the SEU for providing sera, to Jaap Middeldorp for providing anonymised EBV-seronegative sera, to Mark Jitlal for his help in data extraction from the ELGP database, and to all the volunteers and patients who have provided their data for the study. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Code on Github: https://github.com/benjacobs123456/benjacobs | |
| Cold Spring Harbor Laboratory Press | |
| 2020 | |
| Preimpreso | |
| https://www.medrxiv.org/content/10.1101/2020.01.21.20018317v1 | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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