Effect of material deprivation on Epstein-Barr virus infection in Hodgkin's disease in the West Midlands

We have used Townsend scores from postcode data to compare levels of materi al deprivation and Epstein-Barr virus (EBV)-positivity for 223 patients dia gnosed with Hodgkin's disease (HD) in the period 1981-1997. The presence of EBV in HD tumours was determined using in situ hybridization to target the abundantly expressed EBV early RNAs. EBV was detected in the malignant Hod gkin and Reed-Sternberg cells in 47/223 HD cases (21%). There was found to be a tendency for higher Townsend scores (indicative of higher levels of ma terial deprivation) in EBV-positive HD patients, but this association was n ot statistically significant. When various subgroups of patients from the s tudy were examined separately the indication of higher Townsend scores in E BV-positive patients was found to be more marked for patients with mixed ce llularity disease (P = 0.09) and for females (P = 0.03). The results of thi s study suggest that differences in the level of material deprivation are i mportant in determining the likelihood of EBV-positive HD in the UK, partic ularly for certain subgroups of patients. It is not known what specific soc ioeconomic factors are responsible for these differences, although alterati ons in the timing or rate of primary EBV infection, or decline in the level of EBV-specific immunity may be important.