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Epstein-Barr virus (EBV) infection is widely considered to be a risk factor for multiple sclerosis (MS). A previous meta-analysis estimated an odds ratio (OR) for MS in individuals seronegative for EBV of 0.06. Given the potential importance of this finding, we aimed to establish a more precise OR for adult and paediatric onset MS in EBV seronegative individuals.

PubMed and EMBASE searches were undertaken to identify studies investigating the association between MS and EBV. Twenty-two adult and three paediatric studies were included. ORs were calculated using a fixed effects model. A sub-group analysis based on the method of EBV detection was performed.

The OR for developing adult MS in EBV seronegatives was 0.18 (95% confidence interval (CI) 0.13–0.26)) and for paediatric MS was 0.18 (95% CI 0.11–0.30). Sub-group analysis on EBV detection method showed that studies …