almohmeed2013清单正式版本.pdf

Systematic Review and Meta-Analysis of the Sero- Epidemiological Association between Epstein Barr Virus and Multiple Sclerosis 1 1 2 3 Yahya H. Almohmeed , Alison Avenell , Lorna Aucott , Mark A. Vickers * 1 Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom, 2 School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom, 3 Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom Abstract Background: A role for Epstein Barr virus (EBV) in multiple sclerosis (MS) has been postulated. Previous systematic reviews found higher prevalences of anti-EBV antibodies in MS patients compared to controls, but many studies have since been published, and there is a need to apply more rigorous systematic review methods. Methodology/Principal Findings: We examined the link between EBV and MS by conducting a systematic review and meta- analysis of case-control and cohort studies that examined the prevalence of anti-EBV antibodies in the serum of cases and controls. We searched Medline and Embase databases from 1960 to 2012, with no language restriction. The Mantel- Haenszel odds ratios (OR) for anti-EBV antibodies sero-positivity were calculated, and meta-analysis conducted. Quality assessment was performed using a modified version of the Newcastle Ottawa scale. Thirty-nine studies were included. Quality assessment found most studies reported acceptable selection and comparability of cases and controls. However the majority had poor reporting of ascertainment of exposure. Most studies found a higher sero-prevalence of anti-EBNA IgG and anti-VCA IgG in cases compared to controls. The results for anti-EA IgG were mixed with only half the studies finding a higher ser