Serological Detection of Epstein-Barr Virus among Hashimoto's Thyroiditis Patients in Thi-Qar Province

Abstract

Background: Hashimoto's thyroiditis (HT), an autoimmune disease of the thyroid gland that is the leading
cause of hypothyroidism in developed countries, HT may develop at any stage of life, especially between the
ages of 30 and 50 years, and affects both male and female. However, it is usually found in female within a
female-to-male ratio of 10:1. The risk of HT is higher in areas where there is adequate iodine intake, especially
among individuals with genetic predispositions. The prevalence of HT is approximately 2 percent across all age
groups, with an annual incidence of 0.3 to 1.5 cases per 1,000 individuals. HT causes permanent hypothyroidism,
such that the thyroid gland becomes unable to produce hormones, which requires therapeutic replacement. The
TH etiology is multifactorial, incorporating both genetic and environmental factors. Currently, there are no cures
and a limited understanding of the disease mechanisms. However, emerging evidence suggests that viral
infections may serve as potential triggers for HT. The Epstein-Barr virus (EBV) is a double-stranded DNA virus
that demonstrates a distinctive tropism towards B lymphocytes and epithelial tissue. Many studies have linked
the EBV infection to the onset or development of autoimmune diseases, since EBV possesses the ability to
modulate and evade the immune system. A hypothesis suggests that genetically vulnerable B lymphocytes during
the EBV lytic infection infiltrate the thyroid, producing autoantibodies and activating autoreactive T cells. These
autoantibodies then contribute to the autoimmune response that ultimately leads to HT.
Objective: The current study aims to explore the affiliation between HT and EBV infection by comparing the
positive proportions of anti-Epstein-Barr virus viral capsid antigen antibodies (Anti-EBV-VCA) between
patients newly diagnosed by the specialist physician as HT patients and healthy individuals.
Methods: Sixty serum samples from newly diagnosed by the specialist physician as HT patients, 51 females
and 9 males, and sixty healthy controls, 48 females and 12 males, were obtained and tested by the indirect
Chemiluminescence Immunoassay (CLIA) for both Anti-EBV-VCA IgG and Anti-EBV-VCA IgM.
Results: The results did not show any significant difference in the Anti-EBV-VCA IgG positive proportions
between the patients and the healthy groups (P. value= 1), while a significant difference was noticed in the
positive proportions of Anti-EBV-VCA IgM (P. value< 0.001).
Conclusion: Increased positive proportions of VCA-IgM for EBV in the patients with HT compared to the
healthy controls suggest that active EBV infection may have a role in the HT onset or progression