Risk factors

• Associated with high socioeconomic status in childhood (esp. NS in young adults) and with Caucasian race in the USA.

• Familial aggregations frequently reported: 99x 4 risk in identical twins; 7x risk for siblings of young adults (no increase for sibs of older adults); ? genetic or environmental effect.

• Considerable evidence linking EBV to HL: 4 risk of HL in individuals with a history of infectious mononucleosis; EBV encoded nuclear RNAs detected in Reed-Sternberg (RS) cells; 26-50% cases +ve for EBV by molecular analysis (esp. mixed cellularity (MC) subtype).

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