Heterogeneity of risk factors and antibody profiles in epstein-barr virus genome-positive and -negative hodgkin lymphoma

Ellen T. Chang, Tongzhang Zheng, Evelyne T. Lennette, Edward G. Weir, Michael Borowitz, Risa B. Mann, Donna Spiegelman, Nancy E. Mueller

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Background. Hodgkin lymphoma (HL) tumors that contain the Epstein-Barr virus (EBV) genome may differ etiologically from EBV-negative HL tumors. Methods. A case-case study examining heterogeneity of risk factors between disease subgroups compared personal characteristics and EBV antibodies between 95 EBV-positive and 303 EBV-negative patients with HL. Results. We confirmed previous associations of EBV-positive HL with older age, male sex, and mixed-cellularity (MC) histological subtypes. EBV-positive patients were less educated and more likely to have smoked cigarettes and had more prevalent and higher EBV antibody titers, compared with EBV-negative patients. After adjustment for all independent risk factors, those most strongly associated with EBV-positive HL were histological subtypes (odds ratio [OR] for MC vs. nodular sclerosis histology, 3.2; 95% confidence interval [CI], 1.4-7.2), elevated anti-viral capsid antigen level (OR, 3.1; 95% CI, 1.6-6.0), and less education (OR, 0.7; 95% CI, 0.5-1.0). Cigarette smoking and a low anti-Epstein-Barr nuclear protein (EBNA) 1:anti-EBNA-2 ratio were also marginally associated with EBV-positive HL. Conclusions. EBV-positive HL is more common among individuals who have markers of diminished cellular immunity and an abnormal EBV antibody response. EBV appears to participate in the etiology of EBV-positive HL but may not be involved in EBV-negative HL.

Original languageEnglish (US)
Pages (from-to)2271-2281
Number of pages11
JournalJournal of Infectious Diseases
Issue number12
StatePublished - Jun 15 2004

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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