Risk factors for Hodgkin's disease by Epstein-Barr virus (EBV) status: prior infection by EBV and other agents

A UK population-based case-control study of Hodgkin's disease (HD) in young adults (16-24 years) included 118 cases and 237 controls matched on year o f birth, gender and county of residence. The majority (103) of the cases we re classified by Epstein-Barr virus (EBV) status (EBV present in Reed-Stenb erg cells), with 19 being EBV-positive, Analyses using conditional logistic regression are presented of subject reports of prior infectious disease (i nfectious mononucleosis (IM), chicken pox, measles, mumps, pertussis and ru bella). In these analyses HD cases are compared with matched controls, EBV- positive cases and EBV-negative cases are compared separately with their co ntrols and formal tests of differences of association by EBV status are app lied. A prior history of IM was positively associated with HD (odds ratio ( OR) = 2.43, 95% confidence interval (CI)= 1.10-5.33) and with EBV-positive HD (OR = 9.16, 95% CI = 1.07-78.31) and the difference between EBV-positive and EBV-negative HD was statistically significant (P = 0.013). The remaini ng infectious illnesses (combined) were negatively associated with HD, EBV- positive HD and EBV-negative HD (in the total series, for greater than or e qual to 2 episodes compared with less than or equal to 1, OR = 0.45, 95% CI = 0.25-0.83). These results support previous evidence that early exposure to infection protects against HD and that IM increases subsequent risk; the comparisons of EBV-positive and EBV-negative HD are new and generate hypot heses for further study. (C) 2000 Cancer Research Campaign.