Prior exposure to Epstein-Barr virus (EBV) and herpes simplex virus type 1 (HSV-1), in addition to vitamin D deficiency, may increase the risk of developing multiple sclerosis (MS) during childhood, according to research presented at the 2017 Annual Meeting of the American Academy of Neurology (AAN) held April 22-28, in Boston, Massachusetts.
Shayandokht Taleb, MD, from the department of neurology at the University of California, San Francisco, and colleagues conducted a large case-control study recruiting children with MS or clinically isolated syndrome (CIS) and frequency-matched controls from 16 pediatric MS centers across the United States.
Dr. Taleb and colleagues tested EBV-viral capsid antigen, Epstein-Barr nuclear antigen-1, EBV-early antigen, cytomegalovirus, HSV-1 and HSV-2 serostatus, and 25-(OH)-vitamin D levels from 360 children with pediatric-onset MS or CIS (mean age 15.2 ± 3.2; 64% females; mean disease duration 354 days ± 321) and 496 children in the control group (mean age: 14.3 ± 3.8; 52% females).
After adjusting for possible confounders such as age, sex, race, and ethnicity, a remote infection with EBV (anti-EBNA1+) was strongly associated with a higher risk of pediatric-onset MS (OR 3.6; 95% CI 2.1-6.3). HSV-1 seropositivity was also associated with pediatric-onset MS (OR 1.4; 95% CI 1.001-2.011).
There was an increasing trend towards the risk of developing MS in a pediatric population with lower serum levels of vitamin D. There was a 3% reduction in the risk for developing pediatric MS for each 1 mg increase in 25-(OH)-vitamin D serum levels (OR 0.77; 95% CI 0.93-1.01).
“Our preliminary results support an association between prior EBV and HSV-1 infection, and vitamin D deficiency and development of pediatric-onset MS,” concluded the researchers.
Analyses stratifying by DRB1*1501 status are ongoing.
Taleb S, Nourbakhsh B, Graves J, et al. Environmental risk factors associated with pediatric MS: The role of remote viral infections and vitamin D revisited. Presented at: The 2017 AAN Annual Meeting. Boston, Massachusetts; April 22-28. Abstract S44.003.