• Sargis Abrahamyan, Bettina Eberspächer, Muna-Miriam Hoshi, Lilian Aly, Felix Luessi, Sergiu Groppa, Luisa Klotz, Sven G Meuth, Christoph Schroeder, Thomas Grüter, Björn Tackenberg, Friedemann Paul, Florian Then-Bergh, Tania Kümpfel, Frank Weber, Martin Stangel, Antonios Bayas, Brigitte Wildemann, Christoph Heesen, Uwe Zettl, Clemens Warnke, Gisela Antony, Nicole Hessler, Heinz Wiendl, Stefan Bittner, Bernhard Hemmer, Ralf Gold, Anke Salmen, Klemens Ruprecht, German Competence Network Multiple Sclerosis (KKNMS), and Other members of the KKNMS that acted as collaborators in this study.
• Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
• J. Neurol. Neurosurg. Psychiatr. 2020 Jul 1; 91 (7): 681-686.

ObjectiveTo determine the prevalence of antibodies to Epstein-Barr virus (EBV) in a large cohort of patients with early multiple sclerosis (MS).MethodsSerum samples were collected from 901 patients with a clinically isolated syndrome (CIS) or early relapsing-remitting multiple sclerosis (RRMS) participating in the German National MS cohort, a prospective cohort of patients with early MS with stringent inclusion criteria. Epstein-Barr nuclear antigen (EBNA)-1 and viral capsid antigen (VCA) antibodies were measured in diluted sera by chemiluminescence immunoassays (CLIAs). Sera of EBNA-1 and VCA antibody-negative patients were retested undiluted by an EBV IgG immunoblot. For comparison, we retrospectively analysed the EBV seroprevalence across different age cohorts, ranging from 0 to >80 years, in a large hospital population (N=16 163) from Berlin/Northern Germany.ResultsEBNA-1 antibodies were detected by CLIA in 839 of 901 patients with CIS/RRMS. Of the 62 patients without EBNA-1 antibodies, 45 had antibodies to VCA as detected by CLIA. In all of the remaining 17 patients, antibodies to EBV were detected by immunoblot. Altogether, 901 of 901 (100%) patients with CIS/RRMS were EBV-seropositive. EBV seropositivity increased with age in the hospital population but did not reach 100% in any of the investigated age cohorts.ConclusionThe complete EBV seropositivity in this large cohort of patients with early MS strengthens the evidence for a role of EBV in MS. It also suggests that a negative EBV serology in patients with suspected inflammatory central nervous system disease should alert clinicians to consider diagnoses other than MS.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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