# HPV, EBV, CMV, and HSV in Head and Neck Cancer: Molecular Detection, Seroprevalence, and Clinical Correlations

## TL;DR

This study investigates the presence of several viruses in head and neck cancer patients, finding low levels of HPV, EBV, and CMV DNA, and suggests the need for further research and targeted screening.

## Contribution

The study provides new insights into the molecular detection and seroprevalence of specific viruses in head and neck cancer patients.

## Key findings

- HPV types 18, 45, and 69 were detected in tumor tissues, with one patient showing HPV-18 in both blood and tissue.
- Over 90% of patients had IgG antibodies indicating past exposure to CMV, EBV, and HSV-1.
- Viral DNA detection rates were low overall, with no HSV DNA detected in either blood or tumor tissues.

## Abstract

Head and neck cancers constitute a global health burden, and viral pathogens have been implicated in their etiopathogenesis. This study specifically examined cytomegalovirus, Epstein–Barr virus, human papillomavirus and herpes simplex virus at molecular and serological levels in fifty patients in total with histopathologically confirmed head and neck cancer treated at the Department of Otorhinolaryngology, Istanbul Faculty of Medicine. Blood and tumor tissue specimens were collected at diagnosis and analyzed using quantitative molecular assays and serological tests for antibody responses. In peripheral blood, cytomegalovirus and herpes simplex virus DNA were not detected, while Epstein–Barr virus DNA was identified in one patient and human papillomavirus DNA in two. In tumor tissue, cytomegalovirus DNA was detected in five patients, Epstein–Barr virus DNA in six, and human papillomavirus DNA in three, whereas herpes simplex virus DNA was absent. Genotyping revealed human papillomavirus types 18, 45 and 69 in tumor specimens, with one patient positive for type 18 in both blood and tissue. Serology demonstrated that over ninety percent of patients had immunoglobulin G reactivity indicative of past exposure, whereas immunoglobulin M responses were uncommon. Overall viral detection rates were low, yet findings support further multicenter studies and consideration of targeted screening and vaccination strategies.

(1) Background: This study investigated the presence of human papillomavirus (HPV), HPV genotypes, Epstein–Barr virus (EBV), cytomegalovirus (CMV) and herpes simplex virus (HSV) in patients with Head and Neck Cancer (HNC) at both molecular and serological levels. (2) Methods Fifty patients with histopathologically confirmed HNC who were admitted to the Department of Otorhinolaryngology, Istanbul Faculty of Medicine. Viral DNA was detected using quantitative real-time PCR, and serological IgM and IgG antibodies were analyzed using the CMIA method; (3) Results: In blood samples, CMV and HSV DNA were not detected, whereas EBV DNA was identified in 2% and HPV DNA in 4% of patients. In tumor tissues, CMV DNA was detected in 8%, EBV DNA in 10%, and HPV DNA in 6%; HSV DNA is 6%. HPV genotypes 18, 45, and 69 were found in tissue samples. Serologically, IgG positivity for CMV, EBV, and HSV-1 exceeded 90%, whereas IgM positivity was low and not statistically significant; (4) Conclusions: HPV, EBV, and CMV DNA were detected at low frequencies in patients with HNC, while HSV DNA was absent. These findings underline the need for larger multi-center studies and support the consideration of routine viral screening, particularly for HPV, in specific tumor subtypes.