Epstein-Barr virus-associated Hodgkin's disease: Epidemiologic characteristics in international data

Sally L. Glaser, Ruby J. Lin, Susan L Stewart, Richard F. Ambinder, Ruth F. Jarrett, Pierre Brousset, Gorm Pallesen, Margaret L. Gulley, Gulfaraz Khan, Jane O'Grady, Michael Hummel, Maria Victoria Preciado, Hans Knecht, John K C Chan, Alexander Claviez

Research output: Contribution to journalArticle

394 Scopus citations

Abstract

Hodgkin's disease (HD) has long been suspected to have an infectious precursor, and indirect evidence has implicated Epstein-Barr virus (EBV), a ubiquitous herpesvirus, as a causal agent. Recent molecular studies using EBER in situ hybridization or latency membrane protein-1 (LMP-1) immunohistochemistry have identified EBV latent infection in up to 50% of HD tumors. However, the epidemiologic features of these cases have not been examined in detail. To explore the epidemiology of EBV-positive HD so as to understand the role of EBV in HD etiology more clearly, this project accumulated patient data from 14 studies that had applied these EBV assays to HD tumors. With information on age at diagnosis, sex, ethnicity, histologic subtype, country of residence, clinical stage and EBV tumor status from 1,546 HD patients, we examined risk for EBV-positive disease using logistic regression. Forty percent of subjects had EBV-positive tumors, and EBV prevalence varied significantly across groups defined by the study variables. Odds ratios (OR) for EBV-associated HD were significantly elevated for Hispanics vs. whites (OR = 4.1), mixed cellularity vs. nodular sclerosis histologic subtypes (OR = 7.3, 13.4, 4.9 for ages 0-14, 15-49, 50+ years), children from economically less-developed vs. more-developed regions and young adult males vs. females (OR = 2.5). These findings suggest that age, sex, ethnicity and the physiologic effects of poverty may represent biologic modifiers of the EBV association and confirm that this association is strongly but variably linked to histologic subtype. The data augment biologic evidence that EBV is actively involved in HD pathogenesis in some cases but describe epidemiologic complexity in this process.

Original languageEnglish (US)
Pages (from-to)375-382
Number of pages8
JournalInternational Journal of Cancer
Volume70
Issue number4
DOIs
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Glaser, S. L., Lin, R. J., Stewart, S. L., Ambinder, R. F., Jarrett, R. F., Brousset, P., Pallesen, G., Gulley, M. L., Khan, G., O'Grady, J., Hummel, M., Preciado, M. V., Knecht, H., Chan, J. K. C., & Claviez, A. (1997). Epstein-Barr virus-associated Hodgkin's disease: Epidemiologic characteristics in international data. International Journal of Cancer, 70(4), 375-382. https://doi.org/10.1002/(SICI)1097-0215(19970207)70:4<375::AID-IJC1>3.0.CO;2-T