NEOPLASTIC-CELLS OF HODGKINS-DISEASE SHOW DIFFERENCES IN EBV EXPRESSION BETWEEN KENYA AND ITALY

The Epstein-Barr Virus (EBV) has been implicated in the pathogenesis o f Hodgkin's disease (HD). However, the association of EBV with this di sease varies greatly from series to series and from country to country . Epidemiological studies have shown differences in HD occurring in di fferent parts of the world. In particular, it has been reported that H D in developing countries differs from HD in Western countries in term s of epidemiological, pathological and clinical characteristics. These discrepancies among populations suggest an interaction with environme ntal factors and a direct role of different etiological agents. At pre sent, there are no data on the frequency of association of EBV with HD in equatorial Africa. In this study, a large series of HD cases have been collected at the University of Nairobi, Kenya, and at the Univers ities of Bologna and Siena, Italy. The cases have been reviewed and cl assified according to the REAL Classification and the presence of EBV has been assessed by in situ hybridization (ISH). A statistical differ ence in EBV expression was found between HD from Kenya and HD from Ita ly. EBV-positive neoplastic cells were detected in 92% of Kenyan cases , whereas only 48% of Italian cases showed EBER1/2. positivity in the neoplastic cells. Our results suggest that, in Kenya, EBV plays a more direct role in the pathogenesis of HD, as it does for endemic Burkitt lymphoma. (C) 1996 Wiley-Liss, Inc.