Human papillomavirus, Epstein–Barr virus, and Candida albicans co‐infection in oral leukoplakia with different degrees of dysplasia

Abstract

Objectives: To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia.Materials and methods: An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed. Results:The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity. Conclusion:Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.

Prevalence and risk factors for oral HPV16/18 and candida in Japanese people without oral cancer or premalignant lesions

“…9 In addition, co-infection with HPV, C. albicans, and Epstein Barr virus in tongue leukoplakia was involved in dysplastic change of leukoplakia. 10 These results indicate that co-infection with HPV and candida may increase the risk of developing oral cancers. However, the association of oral HPV16/18 with oral candida has not been fully elucidated in Japanese people.…”

HPV co‐infections with other pathogens in cancer development: A comprehensive review

“…[101][102][103] Furthermore, co-infection with HPV and EBV in oral leukoplakia can be associated with severe dysplastic changes. 84 Numerous studies reported the HR-HPVs/EBV co-existence ranging from 27.8% to 100% in HPV-related cervical cancer, and the potential cooperation of EBV as a co-factor in this cancer. 82,83,104 Additionally, a published meta-analysis in 2018 demonstrated that co-infection with HPV increases the risk of cervical cancer in EBV + women up to four-fold.…”

“…Different reports showed the implication of herpesviruses in increasing the risks of cervical dysplasia 82,83 . Co‐infection of HPV with members of herpesviridae especially HSV and EBV was also reported in different studies 83–85 . Regarding HSV, there are two viral genotypes of HSV‐1 and HSV‐2 that are distinguished by envelope antigenic differences, and cause common oral and genital infections worldwide 80 .…”

“…82,83 Co-infection of HPV with members of herpesviridae especially HSV and EBV was also reported in different studies. [83][84][85] Regarding HSV, there are two viral T A B L E 3 Some characteristics of HPV-related cancers in the world. Esophageal cancer Esophagus Men and women Mean age: 65 604 100 [45] Abbreviation: HPV, human papillomavirus.…”

“…It seems likely to be a co‐factor for development of anal and penile cancers in these people 101–103 . Furthermore, co‐infection with HPV and EBV in oral leukoplakia can be associated with severe dysplastic changes 84 . Numerous studies reported the HR‐HPVs/EBV co‐existence ranging from 27.8% to 100% in HPV‐related cervical cancer, and the potential cooperation of EBV as a co‐factor in this cancer 82,83,104 .…”