Prevalence of Co-infection by Human Papillomavirus, Epstein- Barr Virusand Merkel Cell Polyomavirus in Iranian Oral Cavity Cancer andPre-malignant Lesions

Document Type : Original Article

Authors
Sagahr Saber Amoli 1
Ali Hasanzadeh 2
Farzin Sadeghi 3
Mohammad Chehrazi 4
Maryam Seyedmajidi 5
Arghavan Zebardast 6
Yousef Yahyapour 7
1 Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
2 Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
3 Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4 Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
5 Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
6 Department Medical Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
7 Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
10.22088/IJMCM.BUMS.11.1.64
Abstract
Human papillomavirus (HPV) is recognized as the most important risk factor in oral cavity cancer and pre
-
malignant lesions; however, the etiological association of concomitant infection with other oncogenic viruses
as a co
-factor has not been definitively proven. The present study aimed to determine the prevalence of co
-
infection with HPV, Epstein
–Barr virus (EBV) and Merkel Cell PolyomaVirus (MCPyV) in oral cavity lesions
in Iranian patients. One hundred and fourteen oral cavity samples, including 33 oral squamous cell carcinoma,
28 oral lichen planus, 16 oral epithelial dysplasia and 37 oral irritation fibromas were analyzed for the HPV,
EBV and MCPyV infection by quantitative real
-time PCR. According to histological features 32.5% and 28.9%
of cases were oral irritation fibroma and oral squamous cell carcinoma, respectively. Infe
ction with at least two
viruses was detected in 21.1% of patients. In this group, co
-infection with HPV/EBV was identified in 37.5%
of cases, HPV/MCPyV in 29.2%, EBV/MCPyV in 12.5%, and HPV/EBV/MCPyV in 20.8%. There was no
statistically significant difference between multiple infections and anatomical locations of cancer. The
prevalence of triple viral infection (HPV/EBV/MCPyV) in well differentiated tumors was higher than EBV or
MCPyV single infection. This study revealed that co
-infection of HPV, EBV and MCPyV can be detected in
both malignant and non
-malignant oral cavity tissues, and co
-infection with all three viruses in well
differentiated tumors can be shown as a synergistic hypothesis of the pathogenic role of these viruses in oral
malignant transformation.
Keywords
Co-infection
human papillomavirus (HPV), Merkel cell polyomavirus (MCPyV), Epstein–Barrvirus (EBV),Oral lesions