Gender influence in EBV antibody response in multiple sclerosis patients from Kuwait

•MS males have a more progressive MS course than MS females in our study cohort.•EBV immunity in MS patients differs significantly from healthy controls.•Altered EBV immunity in MS patients is influenced by gender.•MS males have a stronger EBV immune response than healthy males.•HLA-DRB1*1501 haplotype does not associate with MS incidence in our MS cohort.

BackgroundEpstein-Barr virus (EBV) infection is implicated with multiple sclerosis (MS) risk, exacerbation, and progression. The HLA-DRB1*1501 haplotype is a strong MS risk factor consistently documented in MS populations. There are no studies of EBV infections and HLA-DRB1*1501 haplotype associating with MS from Kuwait where MS prevalence has increased significantly.ObjectivesTo determine the association of EBV infection with MS incidence, and to investigate HLA-DRB1*1501 as a potential genetic risk factor for MS in Kuwait.MethodsThis is a case-control study involving 141 MS patients and 40 healthy controls. Antibody titers against EBV antigens' viral capsid antigen (VCA) and Epstein-Barr nuclear antigen 1 (EBNA1) were measured using enzyme-linked immunosorbent assays. HLA-DRB1*1501 haplotype assessment was done using rs3135005 TaqMan genotyping assay.ResultsAntibody titers against EBV were significantly elevated in MS patients compared to healthy controls (anti-EBNA1, p = 0.008; anti-VCA, p = 0.028). MS males had higher antibody titers to EBNA1 than healthy male controls (p = 0.005) and female MS patients (p = 0.03). HLA-DRB1*1501 haplotype genotypes failed to generate a risk association with MS or EBV antibody titers (p = 0.6).ConclusionAn increased immune response to EBV infection is associated with MS incidence influenced by the type of antigen and sex. HLA-DRB1*1501 haplotype is not associated with MS risk in our Kuwaiti MS cohort.