What are the links between Epstein-Barr virus, lymphoma, and tumor necrosis factor antagonism in rheumatoid arthritis?

EPSTEIN-BARR VIRUS (EBV) AND RHEUMATOID ARTHRITIS (RA): Patients with (RA) have slightly impaired EBV specific immunity. EBV AND LYMPHOMA: EBV contributes to the development of lymphoma, especially in immunosuppressed patients. LYMPHOMA IN RA: The incidence of lymphoma is increased (2-fold) in patients with active RA. TUMOR NECROSIS FACTOR (TNF) ANTAGONISM, LYMPHOMA, AND RA: The risk to develop lymphoma in patients with RA under TNF inhibitors is slightly higher than that of patients with active RA who do not receive TNF inhibitors. As already demonstrated in the case of posttransplantation lymphoma, EBV load monitoring in patients with RA under TNF inhibitors might allow predicting and preventing the emergence of lymphoma.