Epstein-Barr virus [EBV] in Saudi patients with Hodgkin's disease: relationship to age and subtype

ABSTRACT

The aim of the study was to define the aetiological association of Epstein-Barr virus [EBV] and Hodgkin's disease [HD] among Saudi patients. The relationships between HD and associated EBV, patients age and the various histological subtypes of HD are also assessed. Paraffin - embedded material from 92 cases of histologically proven HD was studied using a sensitive in situ hybridization technique based on the detection of EBV encoded RNA in addition to an immunocytochemical technique for the detection of EBV encoded latent membrane protein [LMP]. The tissue studies consisted of 18 specimens from children, younger than 15 years [mean 7.3 +/- 3.5 years], 54 from young adults between 16 - 45 years of age [mean 36.4 +/- 4.5 years] and 20 from older adults between 46 - 71 years of age [mean 62.3 +/- 4.5 years]. The statistical differences between different age categories were assessed and p-values less than 0.05 was considered significant. In the 92 cases of HD studied, mixed cellularity [MC] was the most common histological subtype [50%] followed by nodular sclerosis [NS] [30.4%], lymphocyte depleted [LD] [10.9%] of cases and lymphocyte predominant [8.7%]. EBV genome was detected in 56 patients [61% of the total number of cases]. There was an almost complete agreement between the results obtained by the two techniques used. Despite the relatively small number of patients which were investigated in this study, it was concluded that EBV infection in Saudi patients is predominantly associated with the mixed cellularity subtype of Hodgkin's disease. The rate of EBV positivity was found to be higher among children and young adults [78 and 63% respectively] than that found in older adults [40%] with a significant statistical p-value of less than 0.05