Infectious mononucleosis and risk for multiple sclerosis: a meta-analysis

Ann Neurol. 2006 Mar;59(3):499-503. doi: 10.1002/ana.20820.


Objective: To characterize the association between infectious mononucleosis (IM), a frequent clinical manifestation of primary Epstein-Barr virus infection after childhood, and the risk for multiple sclerosis (MS).

Methods: We conducted a systematic review and meta-analysis of case-control and cohort studies of IM and MS.

Results: The combined relative risk of MS after IM from 14 studies was 2.3 (95% confidence interval, 1.7-3.0; p < 10(-8)). Potential sources of heterogeneity (ie, study design, MS definition, and latitude) barely influenced our results.

Interpretation: We conclude that Epstein-Barr virus infection manifesting as IM in adolescents and young adults is a risk factor for MS.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Confidence Intervals
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / epidemiology
  • Female
  • Humans
  • Infectious Mononucleosis / complications*
  • Infectious Mononucleosis / epidemiology*
  • Male
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / epidemiology*
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • Risk*