An increased prevalence of Epstein-Barr virus infection in young patients suggests a possible etiology for systemic lupus erythematosus

J Clin Invest. 1997 Dec 15;100(12):3019-26. doi: 10.1172/JCI119856.


An unknown environmental agent has been suspected to induce systemic lupus erythematosus (lupus) in man. Prompted by our recent immunochemical findings, we sought evidence for an association between Epstein-Barr 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 patients had seroconverted against Epstein-Barr virus, as compared with only 70% (107 of 153) of their controls (odds ratio 49.9, 95% confidence interval 9.3-1025, P < 0. 00000000001). The difference in the rate of Epstein-Barr virus seroconversion could not be explained by serum IgG level or by cross-reacting anti-Sm/nRNP autoantibodies. No similar difference was found in the seroconversion rates against four other herpes viruses. An assay for Epstein-Barr viral DNA in peripheral blood lymphocytes established Epstein-Barr virus infection in the peripheral blood of all 32 of the lupus patients tested, while only 23 of the 32 matched controls were infected (odds ratio > 10, 95% confidence interval 2.53-infinity, P < 0.002). When considered with other evidence supporting a relationship between Epstein-Barr virus and lupus, these data are consistent with, but do not in themselves establish, Epstein-Barr virus infection as an etiologic factor in lupus.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Antigens, Viral / immunology
  • Capsid Proteins*
  • Child
  • Child, Preschool
  • DNA, Viral / analysis
  • Herpesviridae Infections / complications*
  • Herpesviridae Infections / epidemiology
  • Herpesviridae Infections / immunology
  • Herpesvirus 4, Human* / genetics
  • Herpesvirus 4, Human* / immunology
  • Herpesvirus 4, Human* / isolation & purification
  • Humans
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / virology*
  • Prevalence
  • Tumor Virus Infections / complications*
  • Tumor Virus Infections / epidemiology
  • Tumor Virus Infections / immunology


  • Antibodies, Viral
  • Antigens, Viral
  • Capsid Proteins
  • DNA, Viral
  • Epstein-Barr viral capsid antigen