Introduction: Some studies of Hodgkin's disease support the concept that the disease may be due, directly or indirectly, to a common infectious agent, an infection acquired in late rather than early childhood being associated with an increased risk of oncogenesis. The Epstein-Barr virus is the leading candidate as one of these causative agents, because of its oncogenic properties in the laboratory and its association with two human malignancies, African Burkitt lymphoma and nasopharyngeal carcinoma.
Methods: We studied 49 patients with Hodgkin's disease. The patients were grouped according to the histologic type, clinical symptoms and immune state. The control group of 140 subjects was selected among healthy people. The antibodies against viral capsid antigen were measured with immunoperoxidase test, antibodies to nuclear antigen with anticomplement immunofluorescent test, and antibodies to early antigen with immunofluorescence method.
Result: We found that all patients had antibodies against viral capsid antigen and nuclear antigen. We found an elevated titers for viral capsid antigen in 69% of patients, early antigen in 41% and nuclear antigen in 55% of patients. The incidence of elevated titers (> or = 320 for viral capsid antigen and > or = 40 for early antigen) and nuclear antigen was higher in patients than in control group; the differences were statistically significant. Also, the geometric mean of early viral capsid and of nuclear antibody titers in patients were significantly higher than that in control group (p < 0.01).
Discussion: The possible role of Epstein-Barr virus in Hodgkin's disease has been long investigated in epidemiological studies and the finding of Epstein-Barr antibody has been currently supported by the detection of genomic Epstein-Barr virus in diagnostic cells in some cases of Hodgkin's disease. Hodgkin's disease varies in prevalence, morphologic findings and association with Epstein-Barr virus in different parts of the world. Hodgkin's disease in Yugoslavia and its relationship to Epstein-Barr virus has not yet been studied. In conclusion, our results indicate that elevated titers of antibody against antigens associated with Epstein-Barr virus exist in patients with Hodgkin's disease. Whether this finding reflects a direct role of Epstein-Barr virus or whether this activity is a marker of the effect of a more fundamental factor, is not yet clear.