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An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis

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. Green open access

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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.

Type: Article
Title: An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0012496
Publisher version: http://dx.doi.org/10.1371/journal.pone.0012496
Language: English
Additional information: © 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.
Keywords: EPSTEIN-BARR-VIRUS, CHLAMYDIA-PNEUMONIAE, ASSOCIATION, MS, ANTIBODIES, AGE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1341362
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