The Association Between Borna Disease Virus and Mood Disorders: A Systematic Review and Meta-Analysis

Context: Recent studies on patients with psychiatric disorders suggest a possible association between borna disease virus (BDV) and mood disorders. However, a clear association remains controversial. The current systematic review and meta-analysis study aimed at investigating the association between BDV infection and mood disorders. Methods: The current study was conducted based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. To obtain the evidence, several databases were searched including PubMed, Scopus, ScienceDirect, Web of Science, Em-base, Cochrane Library, PsycINFO, and Google Scholar search engine without time limit until 2017. Heterogeneity of the studies was assessed using Q test and I-2 index. A random effect model was used to estimate the odds ratio (OR) with 95 confidence interval (CI). Results: Meta-analysis of 23 studies comprising 3628 cases and 5,810 controls showed that BDV infection was associated with a significantly increased risk of mood disorders (OR = 1.61; 95 CI: 1.21-2.15, P = 0.001, I-2 = 44). Subgroup analysis was used according to diagnostic method indicating OR was 1.01 (95 CI: 0.37-2.8) for immunofluorescence antibody (IFA), 1.26 (95 CI: 0.5-3.18) for western blot (WB) assay, 1.58 (95 CI: 1.06-2.38) for real-time polymerase chain reaction (RT-PCR), 1.16 (95 CI: 0.24-5.70) for radioligand assay (RLA), 2.55 (95 CI: 1.67-3.88) for enzyme immunoassay (EIA), 2.15 (95 CI: 0.68-6.80) for enzyme-linked immunosorbent assay (ELISA), 3.29 (95 CI: 1.35-7.98) for electrochemiluminescence immunoassay (ECLIA), 4.00 (95 CI: 0.89-17.87) for peptide array, and 1.00 (95 CI: 0.23-4.27) for proliferation assay method. In subgroup analysis of bipolar and unipolar disorder, OR was 1.99 (95 CI: 1.29-3.08, P = 0.002) and 1.16 (95 CI: 0.76-1.76, P = 0.481), respectively. Conclusions: These results can confirm the significant role of BDV infection in mood disorders. Therefore, it might be necessary to consider BDV infection to manage psychiatric disorders.