Serological Evidence of Epstein-Barr Virus Infection and Disease Activity Assessment in Rheumatoid Arthritis: A Case-Control Study in Erbil, Iraq

Epstein-Barr virus (EBV) has been implicated in the pathogenesis of rheumatoid arthritis (RA) through molecular mimicry and immune dysregulation mechanisms. This study aimed to investigate the association between EBV infection markers and RA in patients from Erbil, Iraq, and to explore the relationships between viral antibody levels and disease activity. A case-control study was conducted involving 66 RA patients diagnosed according to ACR-EULAR 2010 criteria and 25 healthy controls from Rizgary Teaching Hospital, Erbil, Iraq. Serum levels of Epstein-Barr Nuclear Antigen-IgG and Viral Capsid Antigen-IgM were measured using Enzyme-Linked Immunosorbent Assay. Disease activity was assessed using the Disease Activity Score 28 (DAS28) scores. RA patients showed significantly higher VCA-IgM seropositivity compared to controls (75.76% vs 20%, p