The role of EBV and HHV-6 infection in demyelinating disease with a consideration of past UVR exposure.

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The marked increase in immune disorders over the past fifty years is thought to reflect modern environmental and lifestyle factors, rather than changes in diagnosis. The hypothesis that has the most evidence to support it is the 'hygiene hypothesis'. That is, that a reduction in early life infection among modern children leads to immune system dysfunction and thus an increase in immune disorders. Delayed child infection, particularly of Epstein-Barr Virus has been prospectively linked to multiple sclerosis (MS) risk. This project aims to document the role of herpes virus (EBV, HHV-6) infection in the onset of first demyelinating events, a precursor to MS. The strength of this proposal is that it lies within an existing study framework - the Ausimmune Study, allowing detailed exploration of related associations with latitude, early life infant contact and past sun exposure. The incidence of MS has doubled from 1.2-100,000 to 2.4-100,000 from 1961 to 1996 in Newcastle, Australia. Although incidence is low, the disease has a median age of first onset of 24 years and progresses to serious disability even with immunomodulatory therapy (50% will need assistance in walking within 13 years) thus the current prevalence of 1 per 1,000 adults in Tasmania and 0.8 per 1,000 in Newcastle represent a serious burden of morbidity.