Prevalence and Prognostic Significance of Epstein–Barr Virus Infection in Classical Hodgkin's Lymphoma: A Meta-analysis

Background and AimsThe prevalence and prognostic significance of Epstein-Barr virus (EBV) infection in classical Hodgkin's lymphomas (cHLs) remain elusive. To examine the epidemiological and prognostic differences between EBV-positive and -negative cHLs, we conducted a meta-analysis of 119 published studies including 13,045 cases.MethodsWe pooled the results of relevant published studies identified using the PubMed and Embase. The effect sizes of outcome parameters were calculated by prevalence, odds ratio (OR), or hazard ratio using a random-effects model.ResultsThe pooled prevalence of EBV infection in cHL was 47.9%, which was significantly higher in Africa and Central and South America than other regions. EBV-positive cHL showed higher incidence in children than in adults (69.7 vs. 41.1%). EBV-positive cHL was significantly related to male (OR = 1.8, 95% CI: 1.510–2.038; p <0.001), mixed cellularity subtype (OR = 3.8, 95% CI: 3.243–4.451; p <0.001), and advanced clinical stages (OR = 1.2, 95% CI: 1.072–1.369; p = 0.002). However, the presence of EBV in cHL was not associated with overall or event-free survival.ConclusionsThe prevalence of EBV differs according to age, sex, region, histologic subtype, and clinical stage of cHL. However, the presence of EBV has little effects on cHL patient's survival.