Seroprevalence of Epstein-Barr Virus Infection in U.S. Children Ages 6-19, 2003-2010

Abstract

BackgroundEpstein-Barr virus (EBV) is a common herpesvirus linked to infectious mononucleosis and multiple cancers. There are no national estimates of EBV seroprevalence in the United States. Our objective was to estimate the overall prevalence and sociodemographic predictors of EBV among U.S. children and adolescents aged 6–19.MethodsWe calculated prevalence estimates and prevalence ratios for EBV seroprevalence using data from the 2003–2010 U.S. National Health and Nutrition Examination Survey (NHANES) for children aged 6–19 (n = 8417). Poisson regression was used to calculate multivariable-adjusted prevalence ratios across subgroup categories (sex, race/ethnicity, parental education, household income, household size, foreign-born, BMI, and household smoking).FindingsOverall EBV seroprevalence was 66.5% (95% CI 64.3%–68.7%.). Seroprevalence increased with age, ranging from 54.1% (95% CI 50.2%–57.9%) for 6–8 year olds to 82.9% (95% CI 80.0%–85.9%) for 18–19 year olds. Females had slightly higher seroprevalence (68.9%, 95% CI 66.3%–71.6%) compared to males (64.2%, 95% CI 61.7%–66.8%). Seroprevalence was substantially higher for Mexican-Americans (85.4%, 95% CI 83.1%–87.8%) and Non-Hispanic Blacks (83.1%, 95% CI 81.1%–85.1%) than Non-Hispanic Whites (56.9%, 95% CI 54.1%–59.8%). Large differences were also seen by family income, with children in the lowest income quartile having 81.0% (95% CI 77.6%–84.5%) seroprevalence compared to 53.9% (95% CI 50.5%–57.3%) in the highest income quartile, with similar results for parental education level. These results were not explained by household size, BMI, or parental smoking. Among those who were seropositive, EBV antibody titers were significantly higher for females, Non-Hispanic Blacks and Mexican-Americans, with no association found for socioeconomic factors.ConclusionsIn the first nationally representative U.S. estimates, we found substantial socioeconomic and race/ethnic differences in the seroprevalence of EBV across all ages for U.S. children and adolescents. These estimates can help researchers and clinicians identify groups most at risk, inform research on EBV-cancer etiology, and motivate potential vaccine development.

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

“…The seroprevalence of EBV antibodies increases with age but varies across populations according to geographic region, ethnicity and socioeconomic status (Balfour et al, 2013;Condon et al, 2014;Dowd et al, 2013;Kagro et al, 1994). In the United States, a seroprevalence survey from 2009 found that around 50% of children between 6-8 years had antibodies against EBV (Balfour et al, 2013).…”

Seroprevalence and Risk Factors for Epstein-Barr Virus Infection in Adults

“…In a study conducted with students of Edinburg University, Higgins et al [12] determined seropositivity rates of 68.1% in males and 78.5% in females, which was a statistically significantly difference. In another study of children between 6-19 years of age, EBV seroprevalence was found to be higher in girls than in boys (68.9%, 64.2%) [13] . A study by Özkan et al [3] demonstrated that women had similar rates to men.…”

“…In contrast, Balfour et al [9] analyzed the relationship between family education level and seropositivity and found that seropositivity was 72% for those who did not attend high school, 63% for high school graduates, and 56% for those with education beyond high school. Another study showed that EBV seropositivity in individuals with education below high school, at the high school level, and beyond high school was 83.5%, 69.5%, and 59%, respectively [13] . As suggested by these studies, higher education level has been linked to better hygiene habits and consequently a lower risk of virus transmission.…”

“…A study analyzing the correlation between income level and EBV seropositivity reported rates of 81% in the lowincome group, 75% in the mid-level income group, and 53.9% in the high-income group [13] . In a seroprevalence study including 283 individuals in Brazil, it was reported that EBV seropositivity increases with decreasing socioeconomic level of the families [14] .…”

Assemblins as maturational proteases in herpesviruses

“…There are eight human herpesviruses and almost all adults are infected with at least one of these viruses [96][97][98][99][100][101][102]. Antiviral therapy is of great importance as herpesvirus infection in immunocompromised patients can evoke cancer or encephalitis and, therefore, death.…”