TY  - JOUR
TI  - An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis
AV  - public
VL  - 5
Y1  - 2010/09/01/
N1  - © 2010 Handel et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This work was funded by the Wellcome Trust [GRANT NUMBER 075491/Z/04] and Medical Research Council [GRANT NUMBER G0801976]. SVR is a Goodger Scholar at the University of Oxford. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
IS  - 9
ID  - discovery1341362
N2  - Background: Multiple sclerosis (MS) appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV) infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM) has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published.Methods/Principal Findings: We performed a Medline search to identify articles published since the original meta-analysis investigating MS risk following IM. A total of 18 articles were included in this study, including 19390 MS patients and 16007 controls. We calculated the relative risk of MS following IM using a generic inverse variance with random effects model. This showed that the risk of MS was strongly associated with IM (relative risk (RR) 2.17; 95% confidence interval 1.97-2.39; p<10(-54)).Discussion: Our results establish firmly that a history of infectious mononucleosis significantly increases the risk of multiple sclerosis. Future work should focus on the mechanism of this association and interaction with other risk factors.
SN  - 1932-6203
PB  - PUBLIC LIBRARY SCIENCE
UR  - http://dx.doi.org/10.1371/journal.pone.0012496
JF  - PLOS ONE
KW  - EPSTEIN-BARR-VIRUS
KW  -  CHLAMYDIA-PNEUMONIAE
KW  -  ASSOCIATION
KW  -  MS
KW  -  ANTIBODIES
KW  -  AGE
A1  - Handel, AE
A1  - Williamson, AJ
A1  - Disanto, G
A1  - Handunnetthi, L
A1  - Giovannoni, G
A1  - Ramagopalan, SV
ER  -