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Epstein-barr virus and risk of non-Hodgkin lymphoma in the Cancer Prevention Study-II and a meta-analysis of serologic studies.

Int J Cancer. 2014 May 15;

Authors: Teras LR, Rollison DE, Pawlita M, Michel A, Brozy J, de Sanjose S, Blase JL, Gapstur SM

Abstract
Epstein-Barr virus (EBV) causes rare malignant lymphomas. The role of EBV in other non-Hodgkin lymphomas (NHL) remains unclear, but mildly reduced immune function could lead to reactivation of EBV and subsequent NHL. We examined the association between prospectively-collected plasma EBV antibodies and NHL risk in the Cancer Prevention Study-II (CPS-II) Nutrition Cohort and conducted a meta-analysis of our and published results. The CPS-II study included 225 NHL cases and 2:1 matched controls. No associations were observed between EBV serostatus or antibody levels and risk of NHL overall. However, when including only the three most common types of NHL (diffuse large B-cell lymphoma, follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma), high compared to low early antigen-diffuse (EA-D) and BZLF1-encoded replication activator (ZEBRA) antibodies were associated with approximately 60% higher risk of NHL. Odds ratios (OR) for EBV nuclear antigen-1 and viral capsid antigen (VCA)-p18 were elevated but not statistically significant. In the meta-analysis, both EA (summary OR=1.52, 95% confidence interval (CI): 1.16-2.00) and VCA (summary OR=1.20, 95% CI: 1.00-1.44) were positively associated with NHL risk. These results suggest EBV may be associated with a wider spectrum of NHL subtypes, but further study is needed to confirm and fully understand these associations. © 2014 Wiley Periodicals, Inc.

PMID: 24831943 [PubMed - as supplied by publisher]

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