Is Epstein Barr Virus the Leading Cause of Multiple Sclerosis?

January 14, 2022

An article on the Harvard website covers research that suggests MS may be caused by the Epstein Barr virus.


Multiple sclerosis (MS), a progressive disease that affects 2.8 million people worldwide and for which there is no definitive cure, is likely caused by infection with the Epstein-Barr virus (EBV), according to a study led by Harvard T.H. Chan School of Public Health researchers.

The team analyzed serum samples taken biennially by the military and determined the soldiers’ EBV status at time of first sample and the relationship between EBV infection and MS onset during the period of active duty. In this cohort, the risk of MS increased 32-fold after infection with EBV but was unchanged after infection with other viruses. Serum levels of neurofilament light chain, a biomarker of the nerve degeneration typical in MS, increased only after EBV infection. The findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.

Alberto Ascherio, professor of epidemiology and nutrition at Harvard Chan School and senior author of the study, says that the delay between EBV infection and the onset of MS may be partially due to the disease’s symptoms being undetected during the earliest stages and partially due to the evolving relationship between EBV and the host’s immune system, which is repeatedly stimulated whenever latent virus reactivates.

ME Association Comment

This is a very large and impressive research study that has examined whether Epstein Barr virus (EBV), the virus that causes glandular fever, also plays a role in causing multiple sclerosis (MS).

A link between EBV and MS has long been queried and there is already some evidence to support this. These results add considerable weight to this hypothesis.

We also know that EBV is a causal factor in a number of malignant conditions including Burkitt's lymphoma (a tumour of the lymphatic system where the body makes an abnormal type of white blood cell called B cells), Non Hodgkin’s lymphoma and nasopharyngeal carcinoma (the nasopharynx connects the back of the nose to the throat).

In relation to ME/CFS, it is also of interest because EBV/glandular fever is probably the most common viral trigger factor for a post-viral fatigue syndrome (PVFS) and ME/CFS in adolescents – where it is thought about 10% of adolescents develop either a persisting PVFS or ME/CFS following glandular fever.

EBV is also a virus that can remain dormant in the body after the initial infection and can then become reactivated.

And there is some evidence (not always consistent) that EBV reactivation occurs in ME/CFS – which can be read here.

Further information on the links between EBV and ME/CFS in relation to acting as a trigger factor and the reactivation of a dormant infection is summarised and referenced in the Research/Infection section of the ME Association ME/CFS/PVFS Clinical & Research Guide (also known as the MEA purple book).

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.

Dr Charles Shepherd
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