Association of Epstein-Barr virus with systemic lupus erythematosus: relation to disease activity and flare-ups

ABSTRACT

To determine the prevalence of IgM, IgG and IgA antibodies against Epstein Barr, virus capsid antigens [EBV-VCA] in systemic lupus erythematosus [SLE] patients and to clarify their relation to disease activity and flare. The study comprised forty adults SLE patients; they were 35 females and 5 males, 'their ages ranged from 21-35 years [mean +/- SD 29.3 +/- 4.2] and forty normal subjects; 36 females and 4 males with a mean age value of 29.2 +/- 3.9 as a control group. Patients were subjected to thorough medical history taking, clinical examination, laboratory investigations, disease activity assessment and disease flare assessment within one year and detection of EBV IgG, IgM and IgA antibodies in the serum against EBV -VCA for patients and control groups. There was non significant difference as regards the prevalence of anti EBV IgG and IgM in both SLE patients and control groups. A significant difference of serum IgA antibody against EBV-VCA between SLE patients and control groups was found; 15/40 [37.5%] vs. 2/40 [5%]; p<0.001. The systemic lupus erythematosus disease activity index [SLEDAI] score was significantly higher in the SLE patients with IgA antibody against EBV-VCA than in the SLE patients without IgA antibody [29 +/- 7.7 VS 23.4 +/- 3.2; p<0.001]. As regard the disease flare we found that the SLE patients with IgA antibody against EBV-VCA had higher prevalence of disease flare compared to those without IgA antibody 10 [66.7%] vs. 2 [8%], p<0.001. The close clinical data association between EBV infection and SLE suggests a possible role of the EBV as a trigger in the Pathogenesis, disease activity and flare of SLE patients. Further, studies should be done to elucidate the complex relationship between EBV infection and SLE patients