Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis

Research output: Contribution to journalJournal articleResearchpeer-review

T.R. Nielsen, K. Rostgaard, J. Askling, R. Steffensen, A. Oturai, C. Jersild, N. Koch-Henriksen, P.S. Sorensen, H. Hjalgrim

BACKGROUND: Both human leukocyte antigen (HLA)-DRB1*15 and Epstein-Barr virus infection presenting as infectious mononucleosis (IM) are recognized as risk factors for multiple sclerosis (MS). However, their combined effect and possible interaction on MS risk is not known. OBJECTIVE: To assess the association between HLA-DRB1*15 and risk of MS in persons with and without IM. METHODS: We compared the prevalence of DRB1*15 in MS patients with (n = 76) and without (n = 1,836) IM with the corresponding distributions in blood donors with (n = 62) and without (n = 484) IM histories. This allowed us to estimate the relative risk of MS associated with DRB1*15 in the presence and absence, respectively, of previous IM. We then estimated the interaction between DRB1*15 and IM as the ratio of the two individual odds ratios. RESULTS: In IM-naive individuals, DRB1*15 carried a 2.4-fold (95% confidence interval [CI], 2.0-3.0) increased MS risk. In contrast, among persons with IM history, DRB1*15 was associated with a 7.0-fold (95% CI, 3.3-15.4) increased MS risk. Thus, the MS risk conferred by HLA-DRB1*15 was 2.9 (95% CI, 1.3-6.5)-fold stronger in the presence than in the absence of IM. Combined with previous results, this result indicates that DRB1*15-positive persons with a history of IM may be at a 10.0-fold (95% CI, 6.0-17.9) increased risk of MS compared with persons who are DRB1*15 and IM-naive. CONCLUSION: DRB1*15 and IM may act in synergy causing MS
Udgivelsesdato: 2009/4
Original languageEnglish
JournalMultiple Sclerosis
Volume15
Issue number4
Pages (from-to)431-436
Number of pages5
ISSN1352-4585
Publication statusPublished - 2009

ID: 19662840