Epstein-Barr virus is the cause of rheumatoid arthritis

Aim. Many studies presented some evidence that EBV might play a role in the pathogenesis of rheumatoid arthritis. Still, there are conflicting reports concerning the existence of EBV in the synovial tissue of patients suffering from rheumatoid arthritis. This systematic review assesses the causal relationship between Epstein-Barr virus (EBV) and rheumatoid arthritis (RA) for gaining a better understanding of the pathogenesis of RA. Methods. This systematic review and meta-analysis aim to answer among other questions the following: Is there a cause effect relationship between Epstein-Barr virus and rheumatoid arthritis? The method of the conditio sine qua non relationship was used to proof the hypothesis without Epstein-Barr virus no rheumatoid arthritis. In other words, if rheumatoid arthritis is present, then Epstein-Barr virus has to be present too. The mathematical formula of the causal relationship k was used to proof the hypothesis, whether there is a cause effect relationship between Epstein-Barr virus and rheumatoid arthritis. Significance was indicated by a p-value of less than 0.05. Results. The studies analysed were able to provide convincing evidence that Epstein-Barr virus is a necessary condition (a conditio sine qua non) of rheumatoid arthritis. Furthermore, the studies analysed provide impressive evidence of a cause-effect relationship between Epstein-Barr virus and rheumatoid arthritis. Conclusion. EBV infection of human synovial tissues is a conditio sine qua non, a conditio per quam of rheumatoid arthritis. In other words, Epstein-Barr virus is the cause of rheumatoid arthritis.