Evidence map›Paper›PMID 32257152›Full record

SynthesisJournal of global health2020

Predictors of Epstein-Barr virus serostatus and implications for vaccine policy: A systematic review of the literature.

Joanne R Winter, Charlotte Jackson, Joanna Ea Lewis, Graham S Taylor, Olivia G Thomas, Helen R Stagg

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.

  1. Pooled it
  2. Sex- and age-specific incidence and fraction of hospital contacts for infectious mononucleosis cases in Denmark in 1977-2011.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
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  15. Circulating Epstein-Barr Virus Antibody Levels as a Biomarker of Socioecological Adversity in Amazonian Ecuador.American journal of human biology : the official journal of the Human Biology Council · 2025
    Article
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  17. Article
  18. Review
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Joanne R WinterCentre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London, London, UK.
Charlotte JacksonCentre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London, London, UK.
Joanna Ea LewisNational Institute for Health Research (NIHR) Health Protection Research Unit in Modelling Methodology and Medical Research Council Centre for Outbreak Analysis and Public Health, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
Graham S TaylorInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Olivia G ThomasInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Helen R StaggCentre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London, London, UK.
University of Birmingham · GBMRC Clinical Trials Unit at UCL · GBNational Health and Medical Research Council · AUUniversity College London · GBUniversity of Edinburgh · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundEpstein-Barr virus (EBV) is an important human pathogen; it infects >90% people globally and is linked to infectious mononucleosis and several types of cancer. Vaccines against EBV are in development. In this study we present the first systematic review of the literature on risk factors for EBV infection, and discuss how they differ between settings, in order to improve our understanding of EBV epidemiology and aid the design of effective vaccination strategies.

methodsMEDLINE, Embase, and Web of Science were searched on 6

resultsSeventy-seven papers met our inclusion criteria, including data from 31 countries. There was consistent evidence that EBV seroprevalence was associated with age, increasing throughout childhood and adolescence and remaining constant thereafter. EBV was generally acquired at younger ages in Asia than Europe/North America. There was also compelling evidence for an association between cytomegalovirus infection and EBV. Additional factors associated with EBV seroprevalence, albeit with less consistent evidence, included ethnicity, socioeconomic status, other chronic viral infections, and genetic variants of HLA and immune response genes.

conclusionsOur study is the first systematic review to draw together the global literature on the risk factors for EBV infection and includes an evaluation of the quality of the published evidence. Across the literature, the factors examined are diverse. In Asia, early vaccination of infants would be required to prevent EBV infection. In contrast, in Western countries a vaccine could be deployed later, particularly if it has only a short duration of protection and the intention was to protect against infectious mononucleosis. There is a lack of high-quality data on the prevalence and age of EBV infection outside of Europe, North America and South-East Asia, which are essential for informing effective vaccination policies in these settings.

Indexed as

Epstein-Barr Virus InfectionsHerpesvirus 4, HumanHerpesvirus VaccinesHumansInfectious MononucleosisPolicyRisk FactorsVaccinesHerpesvirus VaccinesVaccines

Identifiers

PMID32257152
PMCPMC7125428
OpenAlexW2995946071

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.