Preprint Host control of latent Epstein-Barr virus infection, Schmidt et al., 2025

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Epstein-Barr virus (EBV) is a herpes virus that infects around 90-95% of the global population, and is associated with numerous autoimmune and neoplastic diseases. EBV persists in B cells as a life-long latent infection. Despite its relevance to disease development, the biological basis of host control during EBV latent infection remains unknown.

Here, we report the identification of genetic and non-genetic factors that contribute to latent EBV infection control. In the genome sequence (GS) data of blood from 486,315 UK Biobank and 336,123 All of Us participants, we identified short-reads mapping to the EBV genome in 16.2% and 21.8% of individuals, respectively. The detection of EBV-reads (EBVread+) reflected increased viral load, and was associated with HIV infection, intake of immunosuppressive drugs, and current, but not former, smoking. Genome-wide association analyses identified strong associations at the Major Histocompatibility Complex (MHC), including 54 independent HLA-alleles of MHC class I and II, and at 27 genomic regions outside MHC (e.g., loci encompassing ERAP2, CTLA4). Associated genes included genes underlying monogenic susceptibility to EBV infection (e.g., CD70), and novel candidates thereof (e.g., CD226).

In an analysis of individuals with EBV-associated diseases, we observed a higher polygenic burden of EBVread+ for HLA-alleles at MHC class I in multiple sclerosis (driven by HLA-A*02:01), and at MHC class II in rheumatoid arthritis (RA). A phenome-wide association analysis identified a polygenic overlap of EBVread+ with inflammatory bowel disease, hypothyroidism, and type I diabetes (T1D). Mendelian randomization analyses suggested potential causal effects of EBVread+ on RA and T1D. Our results will inform mechanistic studies and therapeutic approaches in EBV-associated diseases. More broadly, our study illustrates how by-products of human GS data can be used to investigate persistent viral infections.

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