Negative interaction between smoking and EBV in the risk of multiple sclerosis: The EnvIMS studyShow others and affiliations
2017 (English)In: Multiple Sclerosis Journal, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 23, no 7, p. 1018-1024Article in journal (Refereed) Published
Abstract [en]
Background: Results from previous studies on a possible interaction between smoking and Epstein-Barr virus (EBV) in the risk of multiple sclerosis (MS) are conflicting. Objectives: To examine the interaction between smoking and infectious mononucleosis (IM) in the risk of MS. Methods: Within the case-control study on Environmental Factors In Multiple Sclerosis (EnvIMS), 1904 MS patients and 3694 population-based frequency-matched healthy controls from Norway, Italy, and Sweden reported on prior exposure to smoking and history of IM. We examined the interaction between the two exposures on the additive and multiplicative scale. Results: Smoking and IM were each found to be associated with an increased MS risk in all three countries, and there was a negative multiplicative interaction between the two exposures in each country separately as well as in the pooled analysis (p=0.001). Among those who reported IM, there was no increased risk associated with smoking (odds ratio (OR): 0.95, 95% confidence interval (CI): 0.66-1.37). The direction of the estimated interactions on the additive scale was consistent with a negative interaction in all three countries (relative excess risk due to interaction (RERI): -0.98, 95% CI: -2.05-0.15, p=0.09). Conclusion: Our findings indicate competing antagonism, where the two exposures compete to affect the outcome.
Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2017. Vol. 23, no 7, p. 1018-1024
Keywords [en]
Multiple sclerosis; epidemiology; risk factors; smoking; Epstein-Barr virus; infectious mononucleosis
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:liu:diva-138895DOI: 10.1177/1352458516671028ISI: 000402620400017PubMedID: 27663872OAI: oai:DiVA.org:liu-138895DiVA, id: diva2:1115935
Note
Funding Agencies|Italian MS Society/Foundation (Fondazione Italiana Sclerosi Multipla, FISM) [2007/R/14, 2008/R/19]; Western Norway Regional Health Authority (Helse Vest) Norway [911421/2008, 911474/2009]; University of Bergen, Norway; Norwegian MS society; Multiple Sclerosis Society of Canada
2017-06-272017-06-272025-02-21