Proteins of herpes virus type 2 IV. Leukocyte inhibition responses to type common antigen(s) in cervix cancer and recurrent herpetic infections

Association between human herpesvirus infection and cervical carcinoma: a systematic review and meta-analysis

BACKGROUND

Cervical cancer (CC) is one of the most common gynecologic tumors among women around the world. Although the etiological role of human papillomavirus (HPV) in CC is well established, other factors in CC carcinogenesis remains unclear. Here, we performed a systematic review and meta-analysis to explore the association between infections of human herpesvirus (HHVs) and CC risk.

METHODS

Embase and PubMed databases were utilized to search the relevant studies. The revised JBI Critical Appraisal Tool was used to assess the quality of the included studies. Prevalence and odds ratios (ORs) with 95% confidence intervals (CI) were calculated to evaluate the association between viral infection and CC or precancerous cervical lesions (PCL).

RESULTS

Totally 67 eligible studies involving 7 different HHVs were included in meta-analysis. We found an increased risk of CC or PCL that was associated with the overall infection of HHVs (CC, OR = 2.74, 95% CI 2.13-3.53; PCL, OR = 1.95, 95% CI 1.58-2.41). Subgroup analysis showed a trend towards positive correlations between herpes simplex virus type 2 (HSV-2) infection and CC (OR = 3.01, 95% CI 2.24 to 4.04) or PCL (OR = 2.14, 95% CI 1.55 to 2.96), and the same is true between Epstein-Barr virus (EBV) infection and CC (OR = 4.89, 95% CI 2.18 to 10.96) or PCL (OR = 3.55, 95% CI 2.52 to 5.00). However, for HSV-1 and cytomegalovirus (HCMV), there was no association between viral infection and CC or PCL. By contrast, the roles of HHV-6, HHV-7, and Kaposi sarcoma-associated herpesvirus (KSHV) in cervical lesions were unclear due to the limited number of studies.

CONCLUSIONS

This study provided evidence that HHVs infection as a whole increase the risk of CC incidence. In addition, some types of HHVs such as EBV and HSV-2 may serve as potential targets in the development of new interventions or therapeutic strategies for cervical lesions.

Recurrent eruptions following unusual solitary coelenterate envenomations

The case history of four patients is presented. The first patient exhibited normal immunologic reactions to large artificial intradermal challenge with jellyfish venom and later, multiple small natural stings. The second patient, presumably envenomated by a jellyfish, had four recurrent cutaneous eruptions in a linear configuration at the same anatomic site. Because her primary coelenterate contact occurred at a time when she was receiving systemic corticosteroids, it is assumed that the eruption due to the initial sting was delayed. The third and fourth patients exhibited recurrent eruptions after solitary envenomations by different coelenterates. These case histories demonstrate that multiple recurrent eruptions may follow solitary envenomations by different subphyla of coelenterates, that the initial eruption induced by the sting may be delayed by the administration of high doses of systemic corticosteroids, and that an immunologic reaction in both the B and T cell systems can follow jellyfish envenomation.

Viruses and gynecologic cancers: herpesvirus protein (ICP 10/AG-4), a cervical tumor antigen that fulfills the criteria for a marker of carcinogenicity

The studies associating infections by herpes simplex virus type 2 (HSV-2) with carcinoma of the human uterine cervix are reviewed within the context of three possible interpretations. Extensive seroepidemiologic evidence indicates that the virus does not grow preferentially in neoplastic tissue, nor is the association of HSV-2 with cervical carcinoma a reflection of their independent relationship to promiscuity. While a number of infectious agents, including other viruses, are associated with cervical atypia, only HSV-2 is a significant risk factor for CIS. In vitro transformation data supporting the oncogenic potential of the virus are summarized, and evidence is presented that an antigen designated ICP 10/AG-4 is a valid candidate for the role of a virus-encoded protein involved in the maintenance of a transformed phenotype. Antibody to AG-4 is IgM, and it is detected by microquantitative complement fixation. With this assay, it is demonstrated that conversion to anti-AG-4 occurs during primary infection with HSV-2; however, it is transient. In testing 1325 patients, a correlation was observed between antibody to AG-4 and cervical carcinoma. Thus, whereas only 11.7% of controls and 7.7% of patients with cancer at other sites are AG-4 seropositive, as many as 49.6% of patients with dysplasia, 63% of those with CIS, and 72.7% of those with invasive cancer are positive for the antibody. Antibody to AG-4 is related to tumor growth. This is evidence by 1) retrospective analyses demonstrating that the proportion of AG-4 seropositive individuals is directly correlated to the state of the disease and 2) prospective study of 209 patients demonstrating loss of antibody in patients with a successfully removed tumor mass and reappearance of AG-4 antibody in cancer recurrence. The possible use of AG-4 (or its antibody) in the diagnosis and monitoring of cervical carcinoma and its treatment is discussed.