A leading hypothesis for the etiology of multiple sclerosis (MS) is that a delayed infection by Epstein-Barr Virus (EBV) generates an abnormal immune response, thereby inducing the disease. EBV is ubiquitous. While asymptomatic in children, the infection produces the clinical entity infectious mononucleosis (IM) when it is delayed until adolescence or young adulthood. Typically, case-control studies have measured exposure to EBV by serology assaying EBV antibodies or by IM self-report. The findings of these studies are not consistent. / Part of the problem in establishing a definite causal relationship between EBV and MS in case-control studies is related to exposure measurement and misclassification. Since neither EBV serology or IM self-report represent a 'gold standard' for exposure, particularly of delayed exposure, it is difficult to estimate the exposure misclassification that would occur in a case-control study, and the subsequent bias in the odds ratio (OR). / These results support that EBV serology is not a good measure of delayed EBV infection due to its lack specificity, and that estimates of association between MS and EBV serology may overestimate or underestimate the OR between MS and IM. EBV is extremely prevalent, and likely to be differentially misclassified by serology. We therefore recommend the use of IM self-report for future case-control studies of MS and EBV.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.82426 |
| Date | January 2005 |
| Creators | Shoucri, Marie-Rose |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 002207886, proquestno: AAIMR12541, Theses scanned by UMI/ProQuest. |
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