THE ROLE OF EPSTEIN-BARR-VIRUS IN HODGKINS-DISEASE FROM DIFFERENT GEOGRAPHICAL AREAS

Recent studies have suggested that Epstein-Barr virus (EBV) may play a role in the aetiology of Hodgkin's disease. To determine the role of EBV in childhood Hodgkin's disease in different geographical areas, im munohistochemical staining and in situ hybridisation were used to anal yse latent membrane protein 1 (LIMP 1) and small nuclear non-transcrib ed RNAs (EBER-1) respectively. Testing for EBV within the Reed-Sternbe rg and Hodgkin's cells was carried out in childhood Hodgkin's disease from 10 different countries. The proportion of LMP 1 positive cases va ried significantly, being 50% of cases from the United Kingdom (38/75) , South Africa (9/18), Egypt (7/14), and Jordan (8/16), 60% from the U nited Arab Emirates (6/10), 70% from Australia (11/16), 81% from Costa Rica (34/42), 88% from Iran (7/8), 90% from Greece (20/22), and 100% of the 56 cases hom Kenya. A sensitive polymerase chain reaction based EBV strain typing technique was established using archival tissues. E BV strain type 1 was shown to be predominant in childhood Hodgkin's di sease from the United Kingdom, South Africa, Australia, and Greece. Ty pe 2 was predominant in Egypt. EBV strain types 1 and 2 were both dete cted in some cases of childhood Hodgkin's disease in the United Kingdo m, Costa Rica, and Kenya. The high incidence of EBV and the presence e specially in developing countries of dual infection with both strain t ypes 1 and 2 may reflect socioeconomic conditions leading to malnutrit ion induced immunological impairment. The possibility of HIV infection also needs to be explored.