THE CONSISTENT ASSOCIATION BETWEEN EPSTEIN-BARR-VIRUS AND HODGKINS-DISEASE IN CHILDREN IN KENYA

Recent studies have suggested that Epstein-Barr virus (EBV) may play a role in the etiology of Hodgkin's disease (HD). In a previous study, we used latent membrane protein 1 (LMP1)-specific antibodies to examin e archival material from 74 British children with HD and found 50% of cases to be positive, It is known that there are geographic and ethnic variations in the incidence of HD, We have investigated LMP1 status i n formalin-fixed, paraffin wax-embedded lymph nodes with HD involvemen t from 53 children and 48 adults from Kenya using immunohistochemical staining. We also developed sensitive and specific in vitro gene ampli fication protocols for examining the EBV strain type in such material using several combinations of primers derived from the EBNA 2 and EBNA 3 coding regions, LMP1 positivity was present in 100% of the pediatri c cases (two lymphocyte-predominant, 25 nodular sclerosis, 16 mixed ce llularity, 5 lymphocyte depletion, and 5 unclassified) and in 66% of t he adult cases (two of three lymphocyte-predominant, 26 of 39 nodular, sclerosis, two of two mixed cellularity, and two of four lymphocyte d epletion). Tests to type the EBV strain were undertaken in 25 EBV-posi tive pediatric cases. A combination of type-specific polymerase chain reactions for EBNA 2 and EBNA 3C genes indicated that seven patients h ad type 1, eight had type 2, and 10 had dual infections with both type s, Five cases with dual infections were further investigated using a s ensitive in situ hybridization for the EBV-encoded, small nuclear nonp olyadenylated RNAs (EBERs), EBER transcripts were detected in Reed-Ste rnberg and Hodgkin cells and in occasional infiltrating lymphocytes. T hese observations indicate that in Kenya EBV is consistently associate d with pediatric cases of HD, and that biopsies from a number of such cases appear to carry both type 1 and type 2 viral sequences. (C) 1996 by The American Society of Hematology.