Cytomegalovirus seropositivity is negatively associated with multiple sclerosis

• Published in: Multiple sclerosis 2014-02, Vol.20 (2), p.165-173
• Main Authors: Sundqvist, E, Bergström, T, Daialhosein, H, Nyström, M, Sundström, P, Hillert, J, Alfredsson, L, Kockum, I, Olsson, T
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; case-control study; Cytomegalovirus; Cytomegalovirus Infections - epidemiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; environmental factors; Female; Humans; Immunomodulators; Infectious diseases; Infectious Medicine; Infektionsmedicin; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Multiple sclerosis; Multiple Sclerosis - virology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Pharmacology. Drug treatments; Viral diseases; viral infections; Young Adult
• ISSN: 1352-4585; 1477-0970; 1477-0970
• DOI: 10.1177/1352458513494489

Background: Epidemiological data suggest a role for common viruses in the pathogenesis of multiple sclerosis (MS), and recent data showed a negative association of past cytomegalovirus (CMV) infection on pediatric MS risk. Objective: Our aim was to analyze the association of CMV infection with MS risk in an adult case-control material. A meta-analysis was performed to validate our findings. Methods: Epidemiological Investigation in MS (EIMS) is a case-control study with incident cases and population-based controls. Anti-CMV antibody titers were measured with ELISA, and HLA-A and DRB1 genotyping was performed with SSP-PCR, in 658 MS cases, who all fulfilled the McDonald criteria for MS, and 786 controls. Results: CMV seropositivity was associated with a decreased MS risk, OR = 0.73 (0.58–0.92 95% CI), p = 0.005, adjusted for index age, gender, smoking, sun exposure, EBNA1 IgG titer and HLA-A*02 and DRB1*15. When we removed all cases and controls younger than 18 years at index, the protective effect was still apparent. Conclusions: CMV is negatively associated with adult-onset MS pathology, consistent with results from a study on pediatric MS cases. It remains to be shown whether this negative association is due to a true protective effect of CMV infection on MS risk.