Host control of persistent Epstein-Barr virus infection, Schmidt et al., 2026

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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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This paper is now officially out on PubMed and online. Took them 7 months but they got it into Nature. some terminology has changed from the above and they dropped reference to the mendelian randomisation from the abstract. Apparently lots of diseases are implicated as being associated with having abundant ebv swirling round. Doesn't mean it can't be part of the pathogenesis of those diseases but perhaps suggests ebv is not the differentiating factor?

https://www.nature.com/articles/s41586-026-10274-4

Nature
2026 Feb 19.

Host control of persistent Epstein-Barr virus infection
Schmidt et al

Abstract

Epstein-Barr virus (EBV) infects ≈90-95% of the global population1,2 and persists in B cells as a life-long infection3. Prior EBV-infection is associated with autoimmune and neoplastic disease4. Still, the biological basis of host control during EBV persistence remains unclear. Here, we report the identification of non-genetic and genetic factors that are associated with EBV control during persistent infection. Using blood-based genome sequence (GS) data from 486,315 UK Biobank and 336,123 All of Us participants, we identified short read-pairs mapping to the EBV genome in 16.2% and 21.8% of individuals, respectively.

EBV-read detection (EBVread+) reflects increased viral load in blood cells, as shown by orthogonal measurements, and was associated with HIV infection, immunosuppressive drug intake, and current smoking. Genome-wide analyses of EBVread+ 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. Epistasis with distinct HLA-alleles of MHC class I was observed at the ERAP2 locus.

Analysis of individuals with EBV-associated diseases4 revealed 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. Phenome-wide analyses identified a polygenic overlap of EBVread+ with inflammatory bowel disease, hypothyroidism, and type 1 diabetes. Our study establishes by-products of human GS as a surrogate marker of EBV viral load. This will facilitate investigation and treatment for EBV and other persistent viral infections.
 
1. Perhaps what's most useful here is that they use reads of the ebv genome found in the UK Biobank, just as a byproduct of sampling blood to get the human genome. It proves to be a reasonable measure of ebv viral load. This could be a good measure to include in a future ME/CFS biobank study.

2. There's a Manhattan plot in there that has no commonalities with the DecodeME one.

3. The proxy for EBV load appears seasonal:
1771810581010.png
 
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