CAN EPSTEIN BARR OR HERPES CAUSE MS

[amers789]

Hi, I have been wanting to ask this question but felt a bit uncomfortable but I need to see what you all have heard regarding any association between these two. I tested positive for the Epstein Barr virus, my results are listed below:
EBV nuclear antigen IgG was 178.0 range postive is > than 22.0
EBV early antigen IgG was 32.4 range positive is > than 11.0
EBV VCA IgG was 91.3 range positive is > than 22.0
EBV VCA IgM was 37.8 range positive is > than 44.0, equivocal is 36.0 to 43.9 and negative is < than 36.0

Can you have EBV get into the brain and cause lesions? Could it cause symptoms of MS?

Also I have HSV II for many years. Currently on suppressive therapy with Acyclovir 400 mg BID but still have outbreaks maybe once every 1-2 months. Also had tried Valtrex in the past.

My question here, is I have never been tested for this HSV II virus but was diagnosed with it way back when I had my first intial outbreak. Can this virus also cross the BBB and cause brain lesions, TN or MS. I have multiple T2 hyperintense lesions in frontal lobe white matter, periventricular, right and left insula , which I think is the subcortical supratentorial white matter. My only diagnosis currently since Dec 07 is TN. I had a positive LP back in Dec which showed 4 oligoclonal bands in CSF not in serum. All other mimic tests are negative so far except I do have a high ANA 1:640 and Reynauds. Only other abnormal blood test was low Vit D 25 OH which was 22. But the TSH, CBC, CMP, lyme titer, B12, folic acid, urine and blood electrophoresis negative for monoclonal proteins. Also normal ESR, and I said all mimics negative: including lupus, scleroderma, C3 and C4 ENA, anticardiolipin,Beta 2 glycoprotein and Histone.

Thanks for reading all that, I know confusing. My current symptoms are TN, bilateral tinnitus and bilateral parasthesias of toes. I also continue to have relapses where my tip of tongue and lips go numb. Just had a EMG and it was negative, maybe some very small fiber neuroapathy.

So can either of the above viruses cause MS , if so is there any other treatment to kill the viruses, maybe like a IV strength antiviral that would cross BBB. I am so tired of feeling horrible and not knowing what is going on. Thanks for your help and support.

Amers

[starryeyes1]

Its eery> I had mono as a teen, my dad has MS and so there is the genetic portion, I had roseola as a baby, and most likely had very low vitamin d since living in Wa for years, it does make me wonder if I was predisposed to this all along.

Thanks Quix for the information. It makes me want to really prevent this from happening to my girls.

Take care everyone!

Kristi

[amers789]

Thanks Double Vision,  That was a very interesting article and it did make some sense to me.

Ess I did have mono as a teenager, and I guess that is why my titers show a past infection. All information does get a bit confusing so don't worry it is not just you. There is a lot to absorb and understand.

Quix, Thanks for all the great information. It is interesting to note that there may be a link between the EBV and MS, but I do understand it does not cause MS. I know I need to stop self diagnosing myself...lol...just feel like someone should. I guess I was just curious if either of those viruses are linked. So thanks for info. I am disappointed that there is no treatment, so even if it was a bad case of EBV there is nothing they could do anyways. I was just hoping...Thanks again for your help. I see my rheumatologist in another week and I am hoping she can help to do some more research for me, at least believe me that these are valid symptoms. Have a great week all.
Amers

[Quixotic1]

Well, I can answer a couple of your questions.  

EBV (a Herpes virus) does not CAUSE MS - at least not directly.  It does appear to have an important role in setting a person up to develop MS, but there are other factors that clearly have some role, too, such as genetics (again, not directly, but by increasing the "susceptibility" perhaps), and low Vitamin D.  All of these have strong evidence for being risk factors in MS.

Then, there is the unknown possibility that CCSVI might play.

HHS (Herpes Simplex Virus) has no evidence of being a risk factor in MS.

There is some good evidence that HHV-6 (Human Herpes Virus - #6) may also play a role in increasing the risk for MS.  This is the virus that causes the febrile illness in childhood, called Roseola.  The data is not as strong as it is for EBV.

Yes, EBV sometimes causes an encephalitis.  It does cross the BBB, but rarely causes permanent brain lesions.  I found one report of MRI signal abnormalities in a person with EBV encephalitis, but these resolved.

Ess - MS is not always seen after mononucleosis.  Many cases of MS never had that form of the infection.  

First let me point out that there are huge stockpiles of blood samples from the last 50 or 60 years that a researcher can go back and check things on.  Also, I think the military has enlistment bloods from millions of men dating back I don't know how long.  Also, there are very complete National databases of blood testing and amybe blood samples from the European Countries with national health services (many of which work quite well).  So it is possible to collect thousands data from thousands of people forming the 5% of people who are not infected with EBV.

I found a huge study looking at blood samples from the 60's.  Looking at may hundreds of people's titers to EBV from the 60's era - they were able to track down a good number of those to see if they had developed MS.   What this study found was that those people with the highest titers of EBV were more likely to develop MS than those with average post-EBV titers.  So this was another piece of evidence that the people whose immune systems mounted the biggest response to EBV were more likely to get MS.  Mononucleosis is a huge immune-inflammatory response - fever, fatigue, great, swollen tonsils and nodes, and infiltration of the liver and spleen.  When the symptoms are severe they are treated with steroids.

There are no antivirals known to treat EBV - unless something has been found recently.  I'm out of date on the literature now.

Amers - your titers indicate an ongoing infection with EBV.  It looks as though it is past the very acute phase, but you are still showing antigen production.  These are parts of the virus made during active replication.  The  high IgG antibody is lifelong, though your titer is a little elevated and the equivocal IgM is just that -equivocal.  IgM is the first response to an infection, lasts usually several weeks and then gives way to a rising IgG.

So there is a miscellany of EBV and MS stuff.

Quix

[Quixotic1]

I know a little about this - later.  Actually, I know it now, but don't have the time.

Q

[essdipity]

deebs, I'm finding this report confusing. If virtually everyone carries the virus, I wonder how they found enough subjects without the virus to follow. I know it says that the risk of getting MS after this viral infection increases enormously, so that does suggest looking at it as a causal factor. Yet the proportion of MS adults is tiny in comparison to the general population, 95% of whom are said to carry EBV.

So perhaps it's only those who get the serious verson known as mono who are at greater risk. Still, what about those, including me, who may be EBV-positive but have never had mono?

My head is feeling very wooly today, so I'll read all this again tomorrow and maybe I'll understand it better.

ess

[doublevision1]

Here is a recent study you may find helpful, re: the link betweekn EBV and risk of MS:


Researchers Find Further Evidence Linking Epstein-Barr Virus And Risk Of Multiple Sclerosis
Article Date: 05 Mar 2010 - 5:00 PST

Researchers from the Harvard School of Public Health, Walter Reed Army Institute of Research, and a team of collaborators have observed for the first time that the risk of multiple sclerosis (MS) increases by many folds following infection with the Epstein-Barr virus (EBV). This finding implicates EBV as a contributory cause to multiple sclerosis. The study appears in an advance online edition of the journal Annals of Neurology and will appear in a later print edition.

Hundred of thousands of individuals not infected with EBV were followed up for several years through repeated blood samples collections. Researchers were then able to determine the time when individuals developed an EBV infection and its relation to MS onset. "The recruitment of individuals before they were infected with EBV and following up with them for several years is the critical methodological aspect that makes this study qualitatively different from all previous work," said Alberto Ascherio, senior author of the study and professor of epidemiology and nutrition at Harvard School of Public Health and professor of medicine at Harvard Medical School.

MS is a chronic degenerative disease of the central nervous system. Women are more likely than men to get the disease and it is the most common neurologically disabling disease in young adults. Although genetic predisposition plays an important role in determining susceptibility, past studies have shown that environmental factors are equally important.

EBV is a herpes virus and one of the most common human viruses worldwide. Infection in early childhood is common and usually asymptomatic. Late age at infection, however, often causes infectious mononucleosis. In the U.S., upwards of 95% of adults are infected with the virus, but free of symptoms. EBV has been associated with some types of cancer and can cause serious complications when the immune system is suppressed, for example, in transplant recipients. There is no effective treatment for EBV.

This is the first study based on the longitudinal follow-up of several thousand individuals who were not infected with EBV at the time of recruitment. The study population was made up of active-duty US Army, Navy, and Marines personnel who have at least one blood sample in the Department of Defense Serum Repository. The electronic databases of the Physical Disability Agencies of the US Army and Navy were then searched for individuals whose records indicated a possible diagnosis of MS reported between 1992 and 2004.

The researchers selected 305 individuals diagnosed with MS and who had blood specimens collected before the date of their diagnosis. Two controls for each case were then selected from the serum database and matched by branch of service, sex, date of blood collection, and age at time of blood collection.

The study found that MS risk is extremely low among individuals not infected with EBV, but it increases sharply in the same individuals following EBV infection.

"The observation that MS occurred only after EBV is a big step forward," said Alberto Ascherio. "Until now we knew that virtually all MS patients are infected with EBV, but we could not exclude two non-causal explanations for this finding: that EBV infection is a consequence rather than a cause of MS, and that individuals who are EBV negative could be genetically resistant to MS. Both of these explanations are inconsistent with the present findings," said Ascherio.

"The evidence is now sufficiently compelling to justify the allocation of more resources to the development of interventions targeting EBV infection, or the immune response to EBV infection, as these may contribute to MS prevention," he said.

The study was supported by a grant from the National Institute of Neurological Disorders and Stroke.

"Primary Infection with the Epstein-Barr Virus and Risk of Multiple Sclerosis," Lynn I. Levin, Kassandra L. Munger, Eilis J. O'Reilly, Kerstin I. Falk, Alberto Ascherio, Annals of Neurology, online January 20, 2010

Source
Harvard School of Public Health