eprintid: 1341362 rev_number: 27 eprint_status: archive userid: 608 dir: disk0/01/34/13/62 datestamp: 2012-03-01 20:51:11 lastmod: 2021-09-19 23:12:49 status_changed: 2012-03-01 20:51:11 type: article metadata_visibility: show item_issues_count: 0 creators_name: Handel, AE creators_name: Williamson, AJ creators_name: Disanto, G creators_name: Handunnetthi, L creators_name: Giovannoni, G creators_name: Ramagopalan, SV title: An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis ispublished: pub divisions: UCL divisions: B02 divisions: C07 keywords: EPSTEIN-BARR-VIRUS, CHLAMYDIA-PNEUMONIAE, ASSOCIATION, MS, ANTIBODIES, AGE note: © 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. abstract: 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. date: 2010-09-01 publisher: PUBLIC LIBRARY SCIENCE official_url: http://dx.doi.org/10.1371/journal.pone.0012496 vfaculties: VFBRS oa_status: green language: eng primo: open primo_central: open_green article_type_text: Article verified: verified_manual elements_source: Web of Science elements_id: 256599 doi: 10.1371/journal.pone.0012496 language_elements: EN lyricists_name: Giovannoni, Gavin lyricists_id: GGIOV63 full_text_status: public publication: PLOS ONE volume: 5 number: 9 article_number: e12496 issn: 1932-6203 citation: Handel, AE; Williamson, AJ; Disanto, G; Handunnetthi, L; Giovannoni, G; Ramagopalan, SV; (2010) An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis. PLOS ONE , 5 (9) , Article e12496. 10.1371/journal.pone.0012496 <https://doi.org/10.1371/journal.pone.0012496>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/1341362/1/1341362.pdf