AbstractBackgroundMost infections of Epstein-Barr virus (EBV), which is potentially neurotropic, occurred in childhood, but little is known about its association with child neurodevelopmental outcomes.MethodsWe determined whether EBV seropositivity was associated with parent-reported attention deficit hyperactivity disorder (ADHD), learning disability, or special education utilization among children, using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Potential confounding factors were adjusted using survey logistic regression models.ResultsEBV seroprevalence was 69.6% (95% CI, 67.1%-72.1%) for U.S. children aged 6-19. The prevalence was 8.86% (95% CI, 7.47%-10.47%) for ADHD among 6-19 year olds, 11.70% (95% CI, 9.84%-13.87%) for learning disability among 6-15 year olds, and 10.18% (95% CI, 8.58%-12.05%) for special education among 6-17 year olds. Children with positive anti-EBV had higher crude prevalence rates of learning disability and special education but not ADHD compared with those with negative anti-EBV. The adjusted odds ratios were 2.76 (95% CI, 1.53-4.96) for learning disability, 3.58 (95% CI, 1.92-6.55) for special education, and 0.77 (95% CI, 0.42-1.38) for ADHD, when comparing children with positive and negative anti-EBV.ConclusionsEBV seropositivity was associated with learning disability and special education among U.S. children. Future studies that longitudinally examine the associations are warranted.