Associations of Epstein-Barr Virus Infection with Attention Deficit Hyperactivity Disorder, Learning Disability, and Special Education in US Children.

Background: Most infections of Epstein-Barr virus (EBV), which is potentially neurotropic, occur in childhood, but little is known about its association with child neurodevelopmental outcomes.

Patients And Methods: We investigated whether EBV seropositivity was associated with parent-reported attention deficit hyperactivity disorder (ADHD), learning disability, or special education utilization among children, using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Potential confounding factors were adjusted using survey logistic regression models.

Results: EBV seroprevalence was 69.6% (95% CI, 67.1-72.1%) for US children aged 6-19. The prevalence was 8.86% (95% CI, 7.47-10.47%) for ADHD among 6-19 year olds, 11.70% (95% CI, 9.84-13.87%) for learning disability among 6-15 year olds, and 10.18% (95% CI, 8.58-12.05%) for special education among 6-17 year olds. Children with positive anti-EBV had higher crude prevalence rates of learning disability and special education but not ADHD compared with those with negative anti-EBV. The adjusted odds ratios were 2.76 (95% CI, 1.53-4.96) for learning disability, 3.58 (95% CI, 1.92-6.55) for special education, and 0.77 (95% CI, 0.42-1.38) for ADHD, when comparing children with positive and negative anti-EBV.

Conclusion: EBV seropositivity was associated with learning disability and special education among US children. Future studies that longitudinally examine the associations are warranted.