This study was designed to highlight the role of Epstein Barr viruses (EBV) as a possible causative effect in multiple sclerosis (MS) through testing the viral load along with both biochemical and immunological parameters in female MS patients. We also aimed at finding the effects of different types of treatment line on the various study aspects. The results of the enzyme-linked immunosorbent assay (ELISA) revealed first an increased level of EBV EBNA1IgG IL-17A (96.13±27.60 pg/ml) in sera of female MS patients (0.05±0.01 U/ml, n=50) compared with the control group (n=40). We confirmed this result using real-time polymerase chain reaction (RT-PCR) which also showed a significantly higher EBV load in MS patients (22.61±12.72 copies/ml) as compared to the control. This was associated with an increased level of  IL-17A (96.13±27.60 pg/ml) in the patients, while levels of both melatonin hormone (0.63±0.19 pg/ml) and vitamin D3 (29.90±12.41 ng/ml) showed a significant decrease as compared to the normal values of the control group. Analysis of the relation between each of the studied parameters with the level of disability in the patients, as reflected by the expanded disability status score (EDSS), revealed no significant differences between the two categories of  EDSS ˂3 and ≥3 patients in terms of EBV EBNA1IgG levels, whereas they were slightly different in terms of  IL-17A and vitamin D3 (p <0.001). With respect to differences between the treatment lines, the results from the showed analysis of variance (ANOVA) test showed no significant differences in all the tested parameters between patients treated with the first line (Rebif, Avonex, Betaferon) and second-line (Gilenya, Tysabri). However, the only significant difference in comparison to the control group was found in levels of IL-17.      It could be concluded that EBV has a crucial role in the initiation and targeting MS disease, leading to increasing levels of IL-17A, and decrease serum levels of melatonin hormone for female patients.

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