Temporal Relationship Between Elevation of Epstein-Barr Virus Antibody Titers and Initial Onset of Neurological Symptoms in Multiple Sclerosis

Abstract

Elevations of levels of serum antibodies to Epstein-Barr virus (EBV) occurring several years before diagnosis have been characteristically found in diseases probably caused by EBV, such as Burkitt lymphoma¹ and nasopharyngeal carcinoma,² and in Hodgkin disease.³ Anti-EBV antibodies are elevated in individuals with multiple sclerosis (MS),^4,5 and a premorbid increase has been reported in 2 studies,^6,7 but both relied on a single blood sample from each study participant. We therefore conducted a larger prospective investigation using serial blood samples collected several years before onset of MS.