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Mononucleosis As Child, Teen May Up Later Multiple Sclerosis Risk

Infectious mononucleosis during childhood may be a risk factor for subsequent MS diagnosis, independent of shared familial factors

TUESDAY, Oct. 12, 2021 (HealthDay News) — Infectious mononucleosis (IM) during childhood, particularly during adolescence, appears to be a risk factor for subsequent diagnosis of multiple sclerosis (MS), independent of shared familial factors, according to a study published online Oct. 11 in JAMA Network Open.

Yin Xu, Ph.D., from Örebro University in Sweden, and colleagues assessed whether hospital-diagnosed IM during childhood, adolescence, or young adulthood is associated with subsequent MS diagnosis. Individuals born in Sweden from 1958 through 1994 were identified, and participants aged 20 years were followed from 1978 through 2018 for subsequent MS diagnosis.

The researchers found that of the 2,492,980 individuals, 5,867 (0.24 percent) had an MS diagnosis after age 20 years (median age, 31.50 years). There were associations observed between infectious mononucleosis in childhood (hazard ratio [HR], 1.98; 95 percent confidence interval [CI], 1.21 to 3.23) and adolescence (HR, 3.00; 95 percent CI, 2.48 to 3.63) and an increased risk for an MS diagnosis. This association remained significant after controlling for shared familial factors (HRs [95 percent CIs], 2.87 [1.44 to 5.74] and 3.19 [2.29 to 4.46], respectively). The association between infectious mononucleosis in early adulthood and a subsequent MS diagnosis (HR, 1.89; 95 percent CI, 1.18 to 3.05) did not remain significant after controlling for shared familial factors (HR, 1.51; 95 percent CI, 0.82 to 2.76).

“Our findings lend further weight to the notion that Epstein-Barr virus plays a role in pathogenesis, where the pattern of exposure and acute manifestation of the infection are relevant, rather than being a bystander phenomenon due to MS disease activity or susceptibility to MS resulting in a greater likelihood of IM,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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