Acta Neurologica Belgica

, Volume 118, Issue 3, pp 361–377 | Cite as

Infectious agents and different course of multiple sclerosis: a systematic review

  • Alia Saberi
  • Shahin Akhondzadeh
  • Samaneh KazemiEmail author


Multiple sclerosis (MS) causes demyelination of white matter of central nervous system and neuro-degeneration due to inflammation. Different types of MS, as well as disease progression, come with different pathology and pathophysiology. The objective of this study was to evaluate the possible association between different micro-organisms and the relapse or progression of MS. Studies indexed in Medline/PMC, Scopus and Web of Science published without time and language limitation until March 2017 were identified through the search terms “infection” or “infectious” and “multiple sclerosis”. A total of 20878 abstracts were identified through the initial search terms. Selection of articles and assessment of their quality was done based on Cochrane library guidelines. Full texts were reviewed for 33 articles out of which 14 articles met the criteria for inclusion. Different micro-organisms are known to play roles in the pathogenesis of MS and its relapse; including Human herpesvirus 6 (HHV-6), Human herpesvirus 7 (HHV-7), Epstein–Barr virus (EBV), Chlamydia pneumoniae and Torque teno virus (TTV). But in this review only HHV-6, C. pneumoniae and TTV have been considered to play a role in disease progression in some studies and not all of them. This review concluded that some micro-organisms such as HHV-6, C. pneumoniae and TTV have been considered as cofactors to make MS a progressive type. It should be considered that these findings do not necessarily rule out the role of other pathogens in MS progression but may represent population differences or different sensitivity of the technique used.


Infection Multiple sclerosis Relapsing–remitting Progressive 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The authors confirm independence from the sponsors; the content of the article has not been influenced by the sponsors.


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Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  • Alia Saberi
    • 1
  • Shahin Akhondzadeh
    • 2
  • Samaneh Kazemi
    • 3
    Email author
  1. 1.Neuroscience Research Center, Department of Neurology, Poursina Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
  2. 2.Psychiatric Research Center, Roozbeh HospitalTehran University of Medical SciencesTehranIran
  3. 3.Deputy of Research and TechnologyGuilan University of Medical SciencesRashtIran

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