A high proportion of those suffering from Hodgkin's also have the Epstein-Barr virus (EBV). Recent research suggests that this association may not be just a coincidence.

When researchers in Saudi Arabia studied lymph node tissue from 48 patients with nodular sclerosing Hodgkin's disease, they found that 50 per cent of patients showed evidence of EBV infection. All 11 of the patients with grade II Hodgkin's were positive for EBV whereas only 13 (39 per cent) with grade I disease were positive for the virus.

These findings, say the researchers, suggest that EBV plays a causal role in the development of Hodgkin's, with those whose immune systems are functioning poorly at greatest risk.

The scientists propose that, in the presence of a competent immune system, the EBV is neutralised. But in those with a less competent immune system, EBV infection may lead to infectious mononucleosis or Hodgkin's like lymphoproliferative disorder. In patients with more pronounced immunosuppression, EBV infection may lead directly to Hodgkin's disease. If the immunosuppression and/or the viral insult are severe enough, a more aggressive form of Hodgkin's disease is likely to be the result (Cancer, 2001; 91: 1957-63).