Abstract Details

Title Elevated Risk of Multiple Sclerosis and Related Outcomes in Epstein-Barr Virus-Positive Infectious Mononucleosis: A Population-Based Cohort Study

Topic Infectious Disease

Presentation(s) P12 - Poster Session 12 (11:45 AM-12:45 PM)

Poster/Presentation
Number 10-001

Objective To assess risk of multiple sclerosis (MS), demyelinating diseases, and other key outcomes in individuals diagnosed with Epstein-Barr Virus-positive infectious mononucleosis (EBV+ IM).

Background EBV is implicated in the pathogenesis of multiple conditions, but population-based studies are rare.

Design/Methods We studied a population-based cohort of 4,721 individuals diagnosed with EBV+ IM between 01January 1998 and 31December 2022 using data from the Rochester Epidemiology Project (REP). EBV+IM patients were age, sex, and age at index date matched to 14,163 referents without EBV infection. Diagnoses of MS, MS and related demyelinating diseases, splenic rupture, systemic lupus erythematosus (SLE), lymphoid malignancies and death were identified using ICD-9 and ICD-10 codes. Cox proportional hazards models were used to estimate associations between EBV+IM and each outcome. Hazard ratios (HRs) were adjusted for sociodemographic factors, smoking, body mass index, comorbidities, and healthcare utilization the previous year.

Results Median follow-up was 6 years for the EBV+ IM cohort and 8 years for the referents. Individuals with EBV+ IM had a significantly higher risk of MS (adjusted HR 3.03,95% Confidence Interval (CI): 1.15, 8.01), any demyelinating disease (HR: 3.77; 95% CI: 1.61, 8.86), splenic rupture (HR 2.41,95% CI: 1.13, 5.17), and lymphoid malignancies (HR 2.14, 95% CI: 1.01, 4.50). No significant increased risks were observed for SLE (HR 0.98, 95% CI: 0.20, 4.73) or death (HR 1.00, 95% CI: 0.66, 1.51).

Conclusions EBV+ IM significantly raises risks for MS, demyelinating diseases, splenic rupture and lymphoid malignancies. These findings reinforce the need for EBV-targeted preventive strategies. Further research should focus on outcomes in broader populations and with extended follow-up.

Authors/Disclosures
John Diaz-Decaro, PhD, MS PRESENTER	Dr. Diaz-Decaro has received personal compensation for serving as an employee of Moderna. Dr. Diaz-Decaro has stock in Moderna Tx, Inc.
Jennifer L. St Sauver, PhD	The institution of Dr. St Sauver has received research support from NIH, Moderna, and Exact Sciences. The institution of an immediate family member of Dr. St Sauver has received research support from Sanofi.
Robert M. Jacobson, MD	Prof. Jacobson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck & Co.. Prof. Jacobson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Optum. Prof. Jacobson has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Academic Pediatric Association. Prof. Jacobson has stock in 3M Company. Prof. Jacobson has stock in Abbott Laboratories. Prof. Jacobson has stock in AbbVie Company. Prof. Jacobson has stock in Adobe Inc.. Prof. Jacobson has stock in Baxter. Prof. Jacobson has stock in Becton Dickinson & Co. Prof. Jacobson has stock in Eli Lilly & Company. Prof. Jacobson has stock in Embecta. Prof. Jacobson has stock in Hubbell, Inc.. Prof. Jacobson has stock in Johnson & Johnson. Prof. Jacobson has stock in MEDTRONIC PLC F. Prof. Jacobson has stock in RPM INTERNATIONAL. Prof. Jacobson has stock in Schwab Government Money Inv. Prof. Jacobson has stock in Schwab S&P 500 Index. Prof. Jacobson has stock in Solventum Corp. Prof. Jacobson has stock in Takeda Pharma Co.. Prof. Jacobson has stock in ZIMMER BIOMET HLDGS. Prof. Jacobson has stock in Zimvie Inc.. The institution of Prof. Jacobson has received research support from National Institutes of Health. The institution of Prof. Jacobson has received research support from Moderna.
CHUN FAN, MS	Mrs. FAN has nothing to disclose.
Susan A. Hall, PhD	Dr. Hall has received personal compensation for serving as an employee of Moderna. Dr. Hall has stock in Moderna.
Enejda Senko, MS	Ms. Senko has received personal compensation for serving as an employee of Moderna. Ms. Senko has stock in Moderna.
Ali Duarte, MD	Dr. Duarte has nothing to disclose.
Cynthia Crowson (Mayo Clinic)	Cynthia Crowson has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Rheumatology.
Jeffrey Yang, MD	Dr. Yang has nothing to disclose.
Mark Keegan, MD, FAAN (Mayo Clinic)	Dr. Keegan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Keegan has received publishing royalties from a publication relating to health care. Dr. Keegan has received publishing royalties from a publication relating to health care.
Sigrid DaVeiga, MD	Dr. DaVeiga has received personal compensation for serving as an employee of Moderna Therapeutics. Dr. DaVeiga has stock in Moderna Therapeutics.
Philip Buck, PhD	Dr. Buck has received personal compensation for serving as an employee of Moderna, Inc. Dr. Buck has stock in Moderna, Inc.

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