The Epstein-Barr virus (EBV) is a common virus that causes glandular fever (infectious mononucleosis). It has been proposed as a possible trigger for multiple sclerosis.
Although the cause of MS is not understood, it is thought to involve a combination of genes that make someone susceptible to the condition that is then triggered by some environmental factor, such as an infection.
EBV, also called human herpesvirus 4, is a widespread virus, with up to 95% of adults having been exposed. In most people infection does not lead to symptoms or ill health. The prevalence of EBV amongst adults makes it difficult to associate with MS. Infection rates are much lower in children. A Canadian study compared 30 children with multiple sclerosis with 143 controls who didn't have MS. EBV infection was present in 83% of the children with MS patients compared with 42% of the control group.
A study of stored blood samples from 222 US military personnel who had subsequently developed MS found that antibodies to EBV were much higher than in samples from a control group who didn't have the condition.
A meta analysis of 22 studies of the association between EBV and MS in adults and three studies in children found that people with EBV antibodies had a 5.5 times higher risk of MS than those without.
It is not yet clear what the association is between EBV and multiple sclerosis, whether the virus has a direct effect on the condition or whether it triggers other factors in the immune system that lead to the effects of MS.
- Journal of Neurology, Neurosurgery and Psychiatry 2011;82(10):1142-1148. Summary Epstein-Barr virus and multiple sclerosis.
- Journal of the American Medical Association 2004;291(15):1875-1879. Full article Epstein-Barr virus in pediatric multiple sclerosis.
- Multiple Sclerosis Journal 2011;17(10):1185-1193. Summary Anti-Epstein-Barr virus antibodies as serological markers of multiple sclerosis: a prospective study among United States military personnel.
- Multiple Sclerosis Journal 2013;19(2):162-166. Summary The risk of developing multiple sclerosis in individuals seronegative for Epstein-Barr virus: a meta-analysis.
Last updated: November 2017
Last reviewed: March 2014
This page will be reviewed within three years