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An epidemiologic study of index and family infectious mononucleosis and adult Hodgkin's disease (HD): Evidence for a specific association with EBV +ve HD in young adults
Author(s) -
Alexander Freda E.,
Lawrence Davia J.,
Freeland June,
Krajewski Andrew S.,
Angus Brian,
Taylor G. Malcolm,
Jarrett Ruth F.
Publication year - 2003
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.11156
Subject(s) - mononucleosis , odds ratio , medicine , confidence interval , epstein–barr virus , risk factor , case control study , population , immunology , young adult , logistic regression , disease , virus , gastroenterology , environmental health
Infectious mononucleosis (IM) is an established risk factor for Hodgkin's disease (HD). A substantial minority (33%) of cases of HD have Epstein‐Barr virus (EBV) DNA within the malignant cells (are EBV +ve ). It is unclear whether risk after IM applies specifically to EBV +ve HD. We report the results of a population‐based case‐control study of HD in adults ( n = 408 cases of classical HD, 513 controls) aged 16–74 years; the case series included 113 EBV +ve and 243 EBV ‐ve HD. Analyses compared total HD, EBV +ve HD and EBV ‐ve HD with the controls and EBV +ve HD with EBV ‐ve HD cases using, mainly, logistic regression. Regression analyses were adjusted for gender, age‐group and socioeconomic status, and were performed for the whole age range and separately for young (< 35 years) and old adults (≥ 35 years); formal tests of effect modification by age were included. For the young adults, reported IM in index or relative was strongly and significantly associated with EBV +ve HD when compared to controls (odds ratio [OR] = 2.94, 95% confidence interval [CI]: 1.08–7.98 and OR = 5.22, 95% CI: 2.15–12.68, respectively). These results may be interpreted as indications that late first exposure to EBV increases risk of HD, especially in young adults; this applies primarily to EBV +ve HD. © 2003 Wiley‐Liss, Inc.