Plasma magnesium is inversely associated with Epstein-Barr virus load in peripheral blood and Burkitt lymphoma in Uganda

Background Epstein-Barr virus (EBV) causes endemic Burkitt lymphoma (eBL). EBV control was improved by magnesium (Mg²⁺) supplementation in XMEN, an X-linked genetic disease associated with Mg²⁺ deficiency, high circulating EBV levels (viral loads), and EBV-related lymphomas. We, therefore, investigated the relationship between Mg²⁺ levels and EBV levels and eBL in Uganda. Methods Plasma Mg²⁺ was measured in 45 women with low or high circulating EBV levels, 40 pediatric eBL cases, and 79 healthy children. Mg²⁺ uptake by T-lymphocytes was evaluated in samples from healthy donors. Results Plasma Mg²⁺ deficiency (plasma level <1.8 mg/dl) was more likely in women with high- vs. low-EBV levels (76.0% vs. 35%; odds ratio [OR] 11.3, 95% CI 2.14–60.2), controlling for age, and in eBL cases than controls (42.0% vs. 13.9%; OR 3.61, 95% CI 1.32–9.88), controlling for sex, age group, and malaria status. Mg²⁺ uptake by T-lymphocytes was related to extracellular Mg²⁺ concentration. Interpretation Plasma Mg²⁺ deficiency is associated with high EBV levels and eBL.