Childhood EBV and contraception


If EBV is the cause of MS then you expect that everybody should be infected with EBV. If people are not infected and get MS the causal link may become tenuous. In this study they look for EBV negative children with MS and find negative people. Does ProfGs idea go down in flames?

They find 25/189 cases and so you would say the EBV hypothesis is on dogey ground.. They look harder and now come to the conclusion that 14/25 were not MS and after a really hard look only 4 cases negative for EBV. However, 4 is enough to question the basis of the idea. So one would say do more tests. It’s there you just have to look harder

MS is rare in EBV-seronegative children with CNS inflammatory demyelination.Nourbakhsh B, Cordano C, Asteggiano C, Ruprecht K, Otto C, Rutatangwa A, Lui A, Hart J, Flanagan EP, James JA, Waubant E.Ann Neurol. 2021 Mar 11. doi: 10.1002/ana.26062.

But every now and then you see apaper and you think em…best keep out of this one.

Santoro JD, Hurtubise B, Rosario JD, Pagarkar D, Wiegand SE, Su E, Ahsan N. Underutilization of contraception in young females with demyelinating disorders. Mult Scler Relat Disord. 2021 Mar 9;51:102881. doi: 10.1016/j.msard.2021.102881.

Background: Demyelinating disorders in young females are frequently treated with immunomodulatory therapy which often have unknown risks to foetuses during pregnancy. In spite of this, there is no literature in this population about the use of contraception. Our objective was to determine the rate of use of contraception used in a real-world cohort of paediatric patients on immunotherapy for demyelinating diseases.

Methods: A retrospective, multi-center, chart-based review was performed. Inclusion criteria was female gender, use of immunotherapy for a demyelinating disorder, and age >11 years.

Results: Fifty-six female patients were identified with an average age of 15.4 years. The most common demyelinating disorders was multiple sclerosis (n = 33, 59%). The most common treatments were rituximab (n = 18, 32%), dimethyl fumarate (n = 13, 23%), IVIg (n = 11, 20%), and fingolimod (n = 11, 20%). Overall, only 16% (n = 9) of patients used contraception at any point during their immunotherapy regimen. Hispanic patients accounted for 41% of the cohort but were uniformly not on contraceptives (p = 0. 02). Contraceptive use did not impact ARR in any disease (p = 0.45).

Conclusions: Contraceptive use in young females with demyelinating disorders is less than 1/3rd of the general population with particular discrepancies in persons of Hispanic/Latino descent.

Now I will just make this point if the sample was loaded with Hispanic/Latino people I am guessing that many are Roman Catholic, maybe neuros need to have a word with the Pope as well as the parents:-(. I guess an imprtant discussion to be had. Furthermore, it is not just children. that need to think about the issues. Angelica M. Roncancio, PhD, Kristy K. Ward, MD, and Abbey B. Berenson, MDThe Use of Effective Contraception among Young Hispanic Women: The Role of Acculturation.

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  • This is an unusual population to study (Hispanic and children). My first reaction is they didn’t look hard enough or they misdiagnosed some children in the study, or both. What would be really interesting, is a longitudinal follow up of both EBV positive and EBV negative groups to see if there is a clinical divergence or later seroconversion.

    • Why would it be unusual?

      Not unusual if the study’s carried out in an area with a high Hispanic population.

      • Most research that we see is done in adults. This is why so many medicines remain unlicensed in children, even though they’re (probably) safe. I can’t remember any studies that I’ve seen in a Hispanic population previously, even when I did a Cochrane review. This may be because I have a bias towards English publications, due to my linguistic limitations. French is my strongest foreign language and there’s no way I’d tackle a scientific paper in French.

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