Journal of Medical Virology 86:1796–1803 (2014) Epstein-Barr Virus Viral Load and Serology in Childhood Non-Hodgkin’s Lymphoma and Chronic Inflammatory Conditions in Uganda: Implications for Disease Risk and Characteristics Jackson Orem, 1,2,3 Sven Sandin, 1 Edward Mbidde, 2,3 Fred Wabwire Mangen, 4 Jaap Middeldorp, 5 and Elisabete Weiderpass 1,6,7,8 * 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden 2 Uganda Cancer Institute, Kampala, Uganda 3 School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda 4 School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda 5 Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands 6 Cancer Registry of Norway, Oslo, Norway 7 Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway 8 Department of Genetic Epidemiology, Folkha¨lsan Research Center, Helsinki, Finland Epstein-Barr virus (EBV) has been linked to malignancies and chronic inflammatory condi- tions. In this study, EBV detection was com- pared in children with non-Hodgkin’s lymphoma and children with chronic inflammatory condi- tions, using samples and data from a case- control study carried out at the Mulago National Referral Hospital between 2004 and 2008. EBV viral load was measured in saliva, whole blood and white blood cells by real-time PCR. Serolog- ical values for IgG-VCA, EBNA1, and EAd-IgG were compared in non-Hodgkin’s lymphoma and chronic inflammatory conditions; and in Burkitt’s lymphoma and other subtypes of non- Hodgkin’s lymphoma. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated. Of the 127 children included (87 males and 40 females; median age 7 years, range 2–17), 96 had non-Hodgkin’s lymphoma (46 Burkitt’s lymphoma and 50 other non-Hodg- kin’s lymphoma), 31 had chronic inflammatory conditions, and only 10% were HIV-positive. The most common clinical presentations for all disease categories considered were fever, night sweats, and weight loss. EBV viral load in whole blood was elevated in Burkitt’s lymphoma com- pared to other non-Hodgkin’s lymphoma (OR 6.67, 95% CI 1.32, 33.69; P-value ¼ 0.04), but EBV viral loads in saliva and white blood cells were not different in any of the disease categories considered. A significant difference in EAd-IgG was observed when non-Hodgkin’s lymphoma was compared with chronic inflammatory conditions (OR 0.19, 95% CI 0.07, 0.51; P-value ¼ 0.001). When compared to chronic inflammatory conditions, EBV viral load was elevated in Burkitt’s lym- phoma, and EA IgG was higher in non-Hodg- kin’s lymphoma. This study supports an association between virological and serological markers of EBV and childhood non-Hodgkin’s lymphoma, irrespective of subtype, in Uganda. J. Med. Virol. 86:1796–1803, 2014. # 2014 Wiley Periodicals, Inc. KEY WORDS: Epstein-Barr virus; children; non-Hodgkin’s lymphoma; Burkitt’s lymphoma; HIV Grant sponsor: Swedish International Development Coopera- tion Agency (SIDA) Institutions where work was performed: The Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; The Mulago National Referral Hospital, Kampala, Uganda; The Uganda Cancer Institute, Kampala, Uganda; The Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda; and The Depart- ment of Pathology at the VU University Medical Center, Amsterdam, the Netherlands Conflicts of interest: none.  Correspondence to: Elisabete Weiderpass, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, Stockholm 171 77, Sweden. E-mail: elisabete.weiderpass@ki.se Accepted 9 May 2014 DOI 10.1002/jmv.23988 Published online 2 June 2014 in Wiley Online Library (wileyonlinelibrary.com).  C 2014 WILEY PERIODICALS, INC.