Association between Epstein-Barr Virus Infection and Systemic Lupus Erythematosus in Chinese Population : A Meta-Analysis / 现代检验医学杂志

ABSTRACT

Objective To investigate the correlation between Epstein-Barr virus (EBV) infection and systemic lupus erythematosus (SLE) in Chinese population by meta-analysis.Methods The following databases such as China National Knowledge Infrastructure (CNKI),Chinese Weipu Database (VIP),PubMed,EMbase,Chinese Biological Medicine Database (CBM),WANFANG Database were searched from inception to July 2017.For a study it had to be a case-control with SLE and controls in Chinese population.The study had to assay serum anti-EBV antibody in each group.Quality assessments were performed using a modified version of the Newcastle-Ottawa scale (NOS).Then meta-analysis was performed using Rev Man 5.3 software and Stata 12.0 software.Mantel-Haenszel odds ratios (OR) for the detection of anti-EBV antibodies were calculated as well as stability evaluated by sensitivity analysis.Egger test was used to evaluate the publication bias.Resuits Seventeen case-control studies were included.These studies included a total of 1 392 SLE cases and 1 647 controls.Twelve studies measured anti EBV viral capsid antigen (EBV VCA) IgG,there was a statistically significant higher seroprevalence of anti-EBV-VCA IgG (P=0.003) in SLE cases compared to controls.Meta-analysis revealed an overall OR of 2.97 (95％ CI=1.43～6.15).Our subgroup analyses failed to demonstrate a significant difference between any of the subgroups considered.The Egger test showed that there was no significant publication bias.Seven studies measured anti-EBV VCA antibodies of the IgA and six studies assayed anti EBV-VCA antibodies of the IgM subclass,Meta-analysis showed a significant association between anti-EBV-VCA IgA,anti-EBV VCA IgM and SLE,with OR =7.01 (95％ CI =4.61 ～10.66),9.34(95％ CI=4.29～20.34) respectively.The percentage of SLE patients positive for anti EBV-VCA IgA and anti-EBV VCA IgM (37.5 ％ and 28.5 ％,respectively) were significantly lower compared with anti-EBV-VCA IgG (90.3 ％).Meta-analysis showed overall OR=1.01 (95％ CI=0.61 ～ 1.67) indicating that the difference in seropositivity rates between SLE and control groups for anti EBV-nuclear antigen1 (EBNA1) IgG was not significant (P =0.97).Conclusion The findings support the hypothesis that infection with EBV predisposes to the development of SLE.