Neurological

Mono in childhood associated with the risk of being diagnosed with multiple sclerosis

Infectious mononucleosis (IM) in childhood and adolescence increases the risk of multiple sclerosis (MS), according to the study results published in the JAMA Network Open.

IM, which often stems from Epstein-Barr virus (EBV), and high levels of anti-EBV nuclear antigen 1 (EBNA-1) antibodies are each associated with an increased risk of MS, but there can be confounding factors, too which include common genetic factors. Previous studies have examined whether common familial genetic and environmental factors might explain the association between IM and MS. In the current study, Swedish researchers examined the association of IM in children, adolescents and early adulthood with the diagnosis of MS in adulthood.

Data from persons (n ​​= 2,492,980; 47.37% women) who were born in Sweden between 1958 and 1994 and whose parents were still alive in 1990 were included in the study. The researchers identified hospital-based MS diagnoses of the individuals and their parents and first-degree relatives. They followed with participants aged 20 years from 1978 to 2018 for a median of 15.38 years.

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Women were at increased risk of being diagnosed with MS ([Hazard Ratio (HR) 2.62]), as well as those whose mothers were older at birth (HR per older year at age 1.07), and those who were the oldest children.

People with IM in childhood (HR 1.98 [95% CI, 1.21-3.23]) or youth (3.00 [95% CI, 2.48-3.63]) were diagnosed with MS more often than those who weren’t. The control for unmeasured common family factors increased this association (HR 2.87.). [95% CI, 1.44-5.74], Hrs. 3.19 [95% CI, 2.29-4.46] respectively). IM in early adulthood had a lower association with the diagnosis of MS (HR 1.89; 95% CI 1.18-3.05), and this association was lost after unmeasured common familial factors were controlled.

When researchers ruled out MS diagnoses at age 24 or younger, they found that an increased risk of being diagnosed with MS was associated with IM in childhood and adolescence (HRs, 3.72.). [95% CI, 1.44-9.56] and 3.96 [95% CI, 2.65-5.90]). When researchers defined the possible occurrence of MS as the first demyelinating disease of the central nervous system after age 20 and excluded people diagnosed with demyelinating disease before age 20, childhood and adolescent IMs were at increased risk for MS -Diagnosis connected.

HRs were not affected by the exclusion of people born after 1987 between an within sibling or full sibling analysis or an exclusion of families with only one living parent in 1990.

Study limitations include some exclusion from IM and MS diagnosis, possible selection bias, inability to assess the onset of MS prior to initial MS diagnosis, and inability to monitor vitamin D levels, smoking levels and adjust the body mass index.

“The results of this population-based cohort study suggest that IM in childhood, and especially adolescence, is associated with a subsequent diagnosis of MS, regardless of common familial factors. Therefore, a higher susceptibility to infection is less likely the explanation, ”the researchers concluded.

Disclosure: Some study authors stated links with biotech, pharmaceutical, and / or device companies. For a full list of author disclosures, see the original reference.

reference

Y. Xu, A. Hiyoshi, KA Smith et al. Association of infectious mononucleosis in childhood and adolescence with the risk of a later multiple sclerosis diagnosis in siblings. JAMA network open. Published online October 11, 2021. doi: 10.1001 / jamanetworkopen.2021.24932

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