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Epstein-barr virus antibody patterns preceding the diagnosis of non-hodgkin's lymphoma

✍ Scribed by Nancy Mueller; Alejandro Mohar; Alfred Evans; Nancy L. Harris; George W. Comstock; Egil Jellum; Knut Magnus; Norman Orentreich; B. Frank Polk; Joseph Vogelman


Publisher
John Wiley and Sons
Year
1991
Tongue
French
Weight
833 KB
Volume
49
Category
Article
ISSN
0020-7136

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✦ Synopsis


Immunosuppressed patients who develop non-Hodgkin's lymphoma (NHL) have abnormal antibody responses against the Epstein-Barr virus (EBV) prior to the diagnosis of malignancy.

To see if this is also true of "spontaneous" cases in the general population, we undertook a collaborative serologic case-control study. From 4 serum banks containing specimens from over 240,000 persons, I04 subjects were identified for whom a blood specimen had been stored an average of 63 months before diagnosis of NHL, and 259 controls matched for age, sex, ethnic group and date of serum collection. The relative risks (RR) for subsequent development of NHL associated with elevated levels of IgG and IgM antibodies against viral capsid antigen were 2.5 (95% confidence interval = I. 1-5.7) and 3.2 (I .3-7.5), respectively; these associations increased with age at diagnosis. For the nuclear antigen, the distribution of titers for cases was more restricted than that of controls, with fewer cases having either elevated or low titers, RR = 0.5 (0.2-1.4) and 0.5 (0.2-1.2), respectively. Cases had significantly lower antibody titers against the cytomegalovirus, RR = 0.4 (0.2-0.9). These findings suggest that, at least for some patients, NHL is preceded by an enhanced level of endogenous immunosuppression with resultant EBV activation. This observation supports the role of EBV either directly in the development of NHL or as a primary marker of immune dysfunction.

'To whom correspondence and reprint requests should be addressed.

'Deceased.


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