AN INCREASED PREVALENCE OF EPSTEIN-BARR-VIRUS INFECTION IN YOUNG-PATIENTS SUGGESTS A POSSIBLE ETIOLOGY FOR SYSTEMIC LUPUS-ERYTHEMATOSUS

An unknown environmental agent has been suspected to induce systemic l upus erythematosus (lupus) in man. Prompted by our recent immunochemic al findings, we sought evidence for an association between Epstein-Bar r virus infection and lupus. Because the vast majority of adults have been infected with Epstein-Barr virus, we chose to study children and young adults, Virtually all (116 of 117, or 99%) of these young patien ts had seroconverted against Epstein-Barr virus, as compared with only 70% (107 of 153) of their controls (odds ratio 49.9, 95% confidence i nterval 9.3-1025, P < 0.00000000001). The difference in the rate of Ep stein-Barr virus seroconversion could not be explained by serum IgG le vel or by cross-reacting anti-Sm/nRNP autoantibodies. No similar diffe rence was found in the seroconversion rates against four other herpes viruses, An assay for Epstein-Barr viral DNA in peripheral blood lymph ocytes established Epstein-Parr virus infection in the peripheral bloo d of all 32 of the lupus patients tested, while only 23 of the 32 matc hed controls were infected (odds ratio > 10, 95% confidence interval 2 .53-infinity, P < 0.002), When considered with other evidence supporti ng a relationship between Epstein-Barr virus and lupus, these data are consistent with, but do not in themselves establish, Epstein-Barr vir us infection as an etiologic factor in lupus.