TY - JOUR
T1 - Heterogeneity of risk factors and antibody profiles in epstein-barr virus genome-positive and -negative hodgkin lymphoma
AU - Chang, Ellen T.
AU - Zheng, Tongzhang
AU - Lennette, Evelyne T.
AU - Weir, Edward G.
AU - Borowitz, Michael
AU - Mann, Risa B.
AU - Spiegelman, Donna
AU - Mueller, Nancy E.
N1 - Funding Information:
Received 4 September 2003; accepted 5 December 2003; electronically published 21 May 2004. Financial support: National Cancer Institute (grants P01 CA069266-01A1 and T32 CA09001-24). Reprints or correspondence: Dr. Ellen Chang, Harvard School of Public Health, Dept. of Epidemiology, 677 Huntington Ave., Boston, MA 02115 (echang@hsph .harvard.edu).
PY - 2004/6/15
Y1 - 2004/6/15
N2 - 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.
AB - 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.
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U2 - 10.1086/420886
DO - 10.1086/420886
M3 - Article
C2 - 15181575
AN - SCOPUS:2942564310
SN - 0022-1899
VL - 189
SP - 2271
EP - 2281
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 12
ER -