In a cohort of 436 relatives of patients with systemic lupus erythematosus (SLE), reactivation of Epstein–Barr virus (EBV) and polymorphisms in EBV-related genes were associated with the eventual development of SLE (average follow-up of 6.3 years). In the 56 individuals who developed SLE, titres of antibodies against EBV antigens (indicative of EBV reactivation) were increased compared with titres in those who did not develop SLE. Polymorphisms in CD40 and IL10 were also associated with increased titres of antibodies against EBV antigens in individuals who developed SLE.