Is Epstein-Barr Virus Linked to Autoimmune Disease?

According to a study published in 2018, a single, common virus called the Epstein-Barr virus (EBV) may interact with your genes to increase your risk of developing any of seven autoimmune diseases. Researchers say the virus appears to "switch on" certain genes that make you more likely to develop an autoimmune disease down the road.

The seven diseases believed to be associated with the Epstein-Barr virus include:

Scientists have known for a long time that the virus was linked to some autoimmune diseases, but this is the first study to link all of these illnesses to EBV and to offer an explanation of how and why they're linked—an important step in understanding this disease class.

Epstein-Barr virus (EBV) positive
jarun011 / Getty Images

Persistence of EBV Infection

The Epstein-Barr virus is one of the most common viruses to infect humans. Almost everyone carries it in their bodies. You most often hear about EBV as the cause of infectious mononucleosis—also called mono or the "kissing disease."

EBV is a member of the herpesvirus family. And like other viruses in this group, you never get rid of EBV once you contract it. EBV typically stays dormant. If it does become active again, a healthy immune system can easily get it back to a dormant state.

In some people, though, the initial infection appears to activate genes that permanently affect how your immune system functions. This is just one of the possible long-term effects of Epstein-Barr virus.

How It Tricks the Immune System

Your immune system's job is to send out specialized cells to kill dangerous things that invade your body, such as viruses and bacteria. In autoimmunity, there's a case of mistaken identity. The immune system starts tagging something that's supposed to be there—such as an organ or a type of tissue—as a dangerous invader. It then starts sending its specialized cells to kill it.

This triggers inflammation and tissue damage, which can cause pain. Fatigue comes on because your body is diverting resources to the fight. Other symptoms depend on what's being damaged. For example, if it's your pancreas, which produces insulin, your body will begin to have trouble processing sugars.

In the 2018 study, published in the medical journal Nature Genetics, researchers looked at the genetic impact of several proteins in EBV. They found that one of them—Epstein-Barr virus nuclear antigen 2 (EBNA2)—interacts with half of the known genes that put someone with European ancestry at risk for lupus. Researchers looked at hundreds of other illnesses and discovered the same association with the other six linked to the virus. (People of other ancestries were not included in this analysis, but are not currently known to have a different risk profile for, at minimum, EBV.)

Predisposition and Gene Switching

Most of us think of genetics as a fixed thing, but it's not that simple. Illness, environmental, and other factors can turn genes on or off. Think of a breaker box: turn one switch off, you lose power to an area of your house. Turn it on, things roar to life. The same is true when it comes to genes and their positive or negative effect on the body.

Many people are born with genetic predispositions to certain illnesses. That doesn't mean they'll develop those diseases, but it means that they could get them under the right circumstances.

What this study demonstrates is that EBV appears to have the ability to switch on genes that cause your immune system to incorrectly target things that are safe. That, plus a genetic predisposition to autoimmune disease, can lead to the illness (be it multiple sclerosis, celiac, lupus, what have you).

Meanwhile, someone without a genetic predisposition to any autoimmune diseases can contract EBV and have no problems with it.

What This Means for You

This is just the first study to demonstrate that EBV has the switching-on ability, and that means the case is far from closed. Further research will need to confirm the link. However, this points to directions for such research, and some scientists are hailing it as a paradigm shift.

In fact, this potentially groundbreaking study has had a swift impact on researchers. A multiple sclerosis study published in 2020 mentioned this study and the potential link between EBV and MS. Researchers added that antiviral treatments for MS are being studied.

Another 2020 study states: "Infection with Epstein-Barr virus (EBV) appears to be necessary for the development of multiple sclerosis." Its authors discuss methods of targeting the virus as a way to treat MS.

If the research is right and there is an association between EBV and autoimmunity, it could lead to more effective treatments for numerous diseases.

Right now, there's no vaccine for EBV. The 2018 study findings may spur more research into a vaccine, since one wouldn't just stop the spread of mono, but could potentially prevent multiple life-long and debilitating diseases.

A Word From Verywell

Chances are good that you'll come in contact with the Epstein-Barr virus at some point in your life. If any of these seven autoimmune diseases run in your family, it's possible that you have a genetic predisposition. If you've been diagnosed with mono, talk to your healthcare provider about the possible increased risk of autoimmune disease and know the symptoms. Early diagnosis and treatment are important to your long-term health.

Frequently Asked Questions

  • What are the symptoms of Epstein-Barr?

    Epstein-Barr virus symptoms include fatigue, fever, inflammation in the throat, swollen lymph nodes, enlarged spleen, inflamed liver, and rash.

  • Can Epstein-Barr be cured?

    No, Epstein-Barr is a chronic virus that cannot be cured, but symptoms can be treated and managed.

  • How do you prevent yourself from getting Epstein-Barr?

    There is currently no vaccine to protect against Epstein-Barr, but you can take steps to avoid catching this virus. Do not kiss or share food or beverages with someone who is or may be infected with the virus.

  • How common is Epstein-Barr?

    Epstein-Barr is very common. About 95% of people will get infected at some point in their lifetimes.

Was this page helpful?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Harley J, Chen X, Pujato M et al. Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunityNat Genet. 2018;50(5):699-707. doi:10.1038/s41588-018-0102-3

  2. Bar-Or A, Pender MP, Khanna R, et al. Epstein-Barr Virus in Multiple Sclerosis: Theory and Emerging ImmunotherapiesTrends Mol Med. 2020;26(3):296‐310. doi:10.1016/j.molmed.2019.11.003

  3. Afrasiabi A, Parnell GP, Swaminathan S, Stewart GJ, Booth DR. The interaction of Multiple Sclerosis risk loci with Epstein-Barr virus phenotypes implicates the virus in pathogenesisSci Rep. 2020;10(1):193. doi:10.1038/s41598-019-55850-z

  4. Centers for Disease Control and Prevention. About Epstein-Barr virus (EBV).

  5. American Family Physician. Common questions about infectious mononucleosis.