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Eliassen E, Lum E, Pritchett J, Ongradi J, Krueger G, Crawford JR, Phan TL, Ablashi D, Hudnall SD. Human Herpesvirus 6 and Malignancy: A Review. Front Oncol 2018; 8:512. [PMID: 30542640 PMCID: PMC6277865 DOI: 10.3389/fonc.2018.00512] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022] Open
Abstract
In order to determine the role of human herpesvirus 6 (HHV-6) in human disease, several confounding factors, including methods of detection, types of controls, and the ubiquitous nature of the virus, must be considered. This is particularly problematic in the case of cancer, in which rates of detection vary greatly among studies. To determine what part, if any, HHV-6 plays in oncogenesis, a review of the literature was performed. There is evidence that HHV-6 is present in certain types of cancer; however, detection of the virus within tumor cells is insufficient for assigning a direct role of HHV-6 in tumorigenesis. Findings supportive of a causal role for a virus in cancer include presence of the virus in a large proportion of cases, presence of the virus in most tumor cells, and virus-induced in-vitro cell transformation. HHV-6, if not directly oncogenic, may act as a contributory factor that indirectly enhances tumor cell growth, in some cases by cooperation with other viruses. Another possibility is that HHV-6 may merely be an opportunistic virus that thrives in the immunodeficient tumor microenvironment. Although many studies have been carried out, it is still premature to definitively implicate HHV-6 in several human cancers. In some instances, evidence suggests that HHV-6 may cooperate with other viruses, including EBV, HPV, and HHV-8, in the development of cancer, and HHV-6 may have a role in such conditions as nodular sclerosis Hodgkin lymphoma, gastrointestinal cancer, glial tumors, and oral cancers. However, further studies will be required to determine the exact contributions of HHV-6 to tumorigenesis.
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Affiliation(s)
- Eva Eliassen
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Emily Lum
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Joshua Pritchett
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Joseph Ongradi
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Gerhard Krueger
- Department of Pathology and Laboratory Medicine, University of Texas- Houston Medical School, Houston, TX, United States
| | - John R Crawford
- Department of Neurosciences and Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, United States
| | - Tuan L Phan
- HHV-6 Foundation, Santa Barbara, CA, United States.,Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, United States
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Gentile G, Micozzi A. Speculations on the clinical significance of asymptomatic viral infections. Clin Microbiol Infect 2016; 22:585-8. [PMID: 27450587 DOI: 10.1016/j.cmi.2016.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 12/12/2022]
Abstract
A detailed understanding of asymptomatic chronic viral infections is critical to analyse their pathogenesis, assess the severity and burden of disease and, where required, optimize public health control measures. Recent studies on herpesviruses showed that the host-virus interactions are modulated by co-infections, emphasizing the relevance of co-infections in determining the clinical expression (from asymptomatic to symptomatic infections) and the severity of herpesvirus-associated diseases (either neoplastic or infectious diseases). To demonstrate causality between viruses (virome) and diseases, Koch's postulates should be adapted adding new knowledge on host-microbe relationship and microbial interactions. In the present review we aim to provide an update on asymptomatic chronic infections and criteria for causality and on the virological, immunological and host-virus interactions in asymptomatic chronic infections in human hosts, focusing on herpetic infections.
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Affiliation(s)
- G Gentile
- Department of Cellular Biotechnologies and Haematology, Sapienza University, Rome, Italy.
| | - A Micozzi
- Department of Cellular Biotechnologies and Haematology, Sapienza University, Rome, Italy
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Gentile G, Antonelli G. Interplay between β herpesviruses and fungal infections in transplant patients: from the bench to the bedside. Future Virol 2015. [DOI: 10.2217/fvl.15.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
ABSTRACT The studies on the interplay between β-herpesviruses (CMV, human herpes viruses 6 and 7) and fungi in immunocompromised hosts, have demonstrated that a detailed knowledge of the interaction between the host and the above infectious agents may have a significant clinical relevance. β-herpesviruses may directly be associated to different pathological conditions and may indirectly be involved in the development of opportunistic infections (e.g., fungal infections), allograft rejection and decreased patient survival. Recent in vitro and in vivo studies have pointed out the importance of the microbiome, exposure to microbes and the innate immune system in determining the risk of developing infections; such microbial interactions may modulate the expression of the infection, change the microbial pathogenicity, or increase the immunosuppression.
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Affiliation(s)
- Giuseppe Gentile
- Department of Cellular Biotechnologies & Hematology, Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University, Rome, Italy
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Abstract
Pathogenetic roles of human herpesvirus (HHV)-6 in lymphoproliferative diseases have been of continued interest. Many molecular studies have tried to establish a pathogenic role for HHV-6 in lymphoid malignancies. However, whether HHV-6 plays a role in these pathologies remains unclear, as positive polymerase chain reaction results for HHV-6 in those studies may reflect latent infection or reactivation rather than presence of HHV-6 in neoplastic cells. A small number of studies have investigated HHV-6 antigen expression in pathologic specimens. As a result, the lack of HHV-6 antigen expression on neoplastic cells argues against any major pathogenic role of HHV-6. The role of HHV-6 in childhood acute lymphoblastic leukemia (ALL) has also been of interest but remains controversial, with 2 studies documenting higher levels of HHV-6 antibody in ALL patients, and another 2 large-scale studies finding no significant differences in HHV-6 seroprevalences between ALL patients and controls. Alternatively, HHV-6 is increasingly recognized as an important opportunistic pathogen. HHV-6 reactivation is common among recipients of allogeneic stem cell transplantation (SCT), and is linked to various clinical manifestations. In particular, HHV-6 encephalitis appears to be significant, life-threatening complication. Most HHV-6 encephalitis develops in patients receiving transplant from an unrelated donor, particularly cord blood, typically around the time of engraftment. Symptoms are characterized by short-term memory loss and seizures. Magnetic resonance imaging typically shows limbic encephalitis. Prognosis for HHV-6 encephalitis is poor, but appropriate prophylactic measures have not been established. Establishment of preventive strategies against HHV-6 encephalitis represents an important challenge for physicians involved with SCT.
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Affiliation(s)
- Masao Ogata
- Department of Hematology, Oita University Faculty of Medicine, Yufu-city, Oita, Japan.
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Seror E, DeVillartay P, Leverger G, Lenoir G. [HHV-6 infection and acute lymphoblastic leukemia in a child]. Arch Pediatr 2007; 15:37-40. [PMID: 18162384 DOI: 10.1016/j.arcped.2007.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Accepted: 09/25/2007] [Indexed: 10/22/2022]
Abstract
We report the case of a child who was infected by HHV-6 and who started an acute lymphoblastic leukemia two months later. This case reminds that an etiologic role have been suggested for many viral infections in some leukemias in childhood, particularly the human herpesvirus 6 (HHV-6).
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Affiliation(s)
- E Seror
- Service de pédiatrie générale, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
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Altieri A, Castro F, Bermejo JL, Hemminki K. Number of siblings and the risk of lymphoma, leukemia, and myeloma by histopathology. Cancer Epidemiol Biomarkers Prev 2006; 15:1281-6. [PMID: 16835324 DOI: 10.1158/1055-9965.epi-06-0087] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Epidemiologic evidence indicates that several markers of exposure to childhood infections are inversely associated with the risk of childhood leukemia and lymphomas. We used the Swedish Family-Cancer Database to assess the effects of number of siblings on the risk of non-Hodgkin's (n = 7,007) and Hodgkin's lymphomas (n = 3,115), leukemias (n = 7,650), and multiple myeloma (n = 1,492) by histopathology. Poisson regression models included terms for age, sex, family history, period, and socioeconomic index. Having four or more siblings compared with none was associated with an excess risk of childhood acute lymphoblastic leukemia [ALL; rate ratio (RR), 2.11; P(trend) = 0.001], acute monocytic leukemia (RR, 2.51; P(trend) = 0.002), and multiple myeloma (RR, 1.34; P(trend) = 0.006). Having three or more older siblings compared with none decreased the risk of acute monocytic leukemia (RR, 0.35; P(trend) = 0.001) and childhood ALL (RR, 0.69; P(trend) = 0.01). The risk of Hodgkin's lymphoma for five or more older siblings compared with none was 0.41 (P(trend) = 0.003). Acute myeloid leukemia, chronic lymphocytic leukemia, and other lymphoproliferative malignancies were not associated with number of siblings. In conclusion, we found an excess risk of childhood ALL and acute monocytic leukemia in large families. However, for ALL, acute monocytic leukemia, and Hodgkin's lymphoma, younger siblings were strongly protected compared with older siblings. The remarkable protective effect of number of older siblings on acute monocytic leukemia is a novel finding of potential interest. Possible interpretations of our findings in the context of a putative infectious etiology are discussed.
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Affiliation(s)
- Andrea Altieri
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg
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Miller CS, Berger JR, Mootoor Y, Avdiushko SA, Zhu H, Kryscio RJ. High prevalence of multiple human herpesviruses in saliva from human immunodeficiency virus-infected persons in the era of highly active antiretroviral therapy. J Clin Microbiol 2006; 44:2409-15. [PMID: 16825357 PMCID: PMC1489493 DOI: 10.1128/jcm.00256-06] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human immunodeficiency virus (HIV) infection is associated with an increased risk for human herpesviruses (HHVs) and their related diseases. Methods for limiting the transmission of HHVs require a better understanding of the prevalence and infectiousness of oral HHVs in HIV-infected patients. We performed quantitative PCR to investigate the prevalence, quantity, risk, and correlates of salivary HHVs from 58 HIV-seropositive individuals in a case control study. HHVs were significantly more prevalent in the salivas of HIV-seropositive persons than in those of the controls (odds ratios [ORs], 4.2 to 26.2; P<or=0.008). In HIV-infected patients, Epstein-Barr virus (EBV), human herpesvirus 8 (HHV-8), cytomegalovirus (CMV), and herpes simplex virus type 1 (HSV-1) were detected in 90%, 57%, 31% and 16% of samples, respectively, compared with 48%, 24%, 2%, and 2%, respectively, of samples from controls. Multiple HHVs were observed in 71% of HIV-seropositive persons and only 16% of controls (OR, 13.0; 95% confidence interval, 5.29 to 32.56). HIV-positive patients had significantly higher EBV loads than HIV-negative persons (P<0.0001). HIV-infected patients with CD4 counts above 200 cells/microl had increased probability for having HHV-8 in saliva (P=0.009) compared with patients whose counts were less than 200. In contrast, HSV-1, EBV, and CMV were detected more often when CD4 counts were low. High salivary HHV loads were detected for those (n=7) with oral lesions. These findings suggest that saliva is a potential risk factor for the acquisition of multiple HHVs, and several host factors may function to accelerate HHV reactivation or replication in patients with HIV infection.
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Affiliation(s)
- Craig S Miller
- Department of Microbiology, Immunology & Molecular Genetics, College of Medicine, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0297, USA.
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Berrington de González A, Urban MI, Sitas F, Blackburn N, Hale M, Patel M, Ruff P, Sur R, Newton R, Beral V. Antibodies against six human herpesviruses in relation to seven cancers in black South Africans: a case control study. Infect Agent Cancer 2006; 1:2. [PMID: 17150131 PMCID: PMC1635002 DOI: 10.1186/1750-9378-1-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 09/14/2006] [Indexed: 11/16/2022] Open
Abstract
Background Infections with certain human herpesviruses have been established as risk factors for some cancer types. For example, Epstein-Barr Virus is considered a cause of Burkitt's lymphoma and other immunosuppression related lymphomas, Hodgkin lymphoma, and nasopharyngeal cancer. Several other human herpesviruses have been linked to cancers but the totality of evidence is inconclusive. Methods We conducted a systematic sub-study from within an ongoing case control study of adult black South Africans to investigate the relationship between antibodies to six human herpesviruses and seven cancer groups that may be caused by infectious agents. Subjects had incident cancers of the oral cavity(n = 88), the cervix(n = 53), the prostate(n = 66), Hodgkin lymphoma(n = 83), non-Hodgkin lymphoma(n = 80), multiple myeloma(n = 94) or leukaemia(n = 203). For comparison, patients with other cancers(n = 95) or cardiovascular disease(n = 101) were randomly selected from within the study. Patients were interviewed and their blood was tested for IgG antibodies against HSV-1, HSV-2, VZV, EBV-EBNA, CMV and HHV-6 using enzyme linked immunosorbent assays. Because these viruses are highly prevalent in this population, optical density results from the assays were used as an indirect, quantitative measure of antibody level. Results There was significant variation in the mean log antibody measures for HSV-2, VZV, CMV and HHV-6 between the disease groups. However, none of the specific cancer groups had significantly higher mean log antibody measures for any of the viruses compared to either control group. In a more detailed examination of seven associations between cancers and herpesviruses for which there had been prior reports, two statistically significant associations were found: a decreasing risk of myeloid leukaemia and an increasing risk of oral cancer with increasing tertiles of antibodies against HHV-6 compared to all other patients (p-trend = 0.03 and 0.02, respectively). Odds ratios for the top tertile compared to the bottom tertile were 0.58 (95%CI 0.3 – 1.0) for myeloid leukaemia and 2.21 (95% CI 1.1 – 4.3) for oral cancer. Conclusion In this population, using these tests for IgG, neither mean antibody measure nor high antibody measure against human herpesviruses 1–6 was strongly associated with any of the seven cancer groups. However, we may not have had sufficient power to detect weak associations or associations with a sub-type of cancer if they were present.
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Affiliation(s)
- A Berrington de González
- Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore MD, 21205, USA
| | - MI Urban
- MRC/NHLS/Wits Cancer Epidemiology Research Group, National Health Laboratory Service, P.O. Box 1038, Johannesburg 2000, South Africa
| | - F Sitas
- MRC/NHLS/Wits Cancer Epidemiology Research Group, National Health Laboratory Service, P.O. Box 1038, Johannesburg 2000, South Africa
- The Cancer Council New South Wales, Sydney, Australia
- The Schools of Public Health, Universities of New South Wales and Sydney, Australia
| | - N Blackburn
- National Institute for Communicable Diseases, National Health Laboratory Service, 1 Modderfontein Road, Sandringham 2131, South Africa
| | - M Hale
- Department of Anatomical Pathology, Chris Hani Baragwanath Laboratory, School of Pathology, University of the Witwatersrand, and National Health Laboratory Service, P.O. Box 1038, Johannesburg 2000, South Africa
| | - M Patel
- Clinical Haematology Division, Department of Medicine, Chris Hani Baragwanath Hospital and the University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - P Ruff
- Division of Medical Oncology, Department of Medicine, Johannesburg Hospital and the University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - R Sur
- Division of Radiation Oncology, Department of Medicine, Johannesburg Hospital and the University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
- Hamilton Regional Cancer Centre, 699 Concession Street, Hamilton, ON L8V 5C2, Canada
| | - R Newton
- Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK
| | - V Beral
- Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK
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Miller CS, Avdiushko SA, Kryscio RJ, Danaher RJ, Jacob RJ. Effect of prophylactic valacyclovir on the presence of human herpesvirus DNA in saliva of healthy individuals after dental treatment. J Clin Microbiol 2005; 43:2173-80. [PMID: 15872238 PMCID: PMC1153765 DOI: 10.1128/jcm.43.5.2173-2180.2005] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human herpesviruses (HHVs) are ubiquitous pathogens that intermittently reactivate from latency. Transmission is believed to be facilitated by their frequent appearance in saliva. This study sought to understand the factors that influence the appearance of these viruses in saliva by examining the prevalence, pattern, and quantity of all eight HHVs in saliva of immunocompetent adults with a history of recurrent oral herpes simplex virus (HSV) infections following dental treatment and antiviral therapy. Valacyclovir or matched placebo was given (2 g twice on the day of treatment and 1 g twice the following day) to 125 patients in a randomized, double-blind controlled trial. Saliva, collected on the day of dental treatment and 3 and 7 days later, was analyzed using real-time quantitative PCR. At all visits, HHVs coinfected saliva. Over the course of the week, the DNAs of HHV-6 and HHV-7 were detected significantly more often (97% to 99% of patients) than Epstein-Barr virus (EBV; 64.8%), HSV-1 (13.0%), HHV-8 (3.2%), cytomegalovirus (2.4%), HSV-2 (0%), and varicella-zoster virus (0%), irrespective of drug treatment (P < 0.002). Mean genome copy numbers were highest for HSV-1 and HHV-6. Dental treatment did not influence asymptomatic viral shedding patterns. However, valacyclovir treatment resulted in significantly fewer patients shedding EBV at both postoperative visits compared with placebo (P < 0.008). These results suggest that HHVs are simultaneously present in the saliva of healthy adults at levels that could facilitate transmission, and valacyclovir therapy decreases the prevalence of EBV in saliva but has little effect on HHV-6 and HHV-7.
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Affiliation(s)
- Craig S Miller
- Department of Microbiology, Immunology & MOlecular Genetics, University of Kentucky College of Medicine and College of Dentistry, Lexington, KY, USA.
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Howe HL, Wingo PA, Thun MJ, Ries LA, Rosenberg HM, Feigal EG, Edwards BK. Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. J Natl Cancer Inst 2001; 93:824-42. [PMID: 11390532 DOI: 10.1093/jnci/93.11.824] [Citation(s) in RCA: 498] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The American Cancer Society, the National Cancer Institute (NCI), the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention, including the National Center for Health Statistics (NCHS), collaborate to provide an annual update on cancer occurrence and trends in the United States. This year's report contains a special feature that focuses on cancers with recent increasing trends. METHODS From 1992 through 1998, age-adjusted rates and annual percent changes are calculated for cancer incidence and underlying cause of death with the use of NCI incidence and NCHS mortality data. Joinpoint analysis, a model of joined line segments, is used to examine long-term trends for the four most common cancers and for those cancers with recent increasing trends in incidence or mortality. Statistically significant findings are based on a P value of.05 by use of a two-sided test. State-specific incidence and death rates for 1994 through 1998 are reported for major cancers. RESULTS From 1992 through 1998, total cancer death rates declined in males and females, while cancer incidence rates declined only in males. Incidence rates in females increased slightly, largely because of breast cancer increases that occurred in some older age groups, possibly as a result of increased early detection. Female lung cancer mortality, a major cause of death in women, continued to increase but more slowly than in earlier years. In addition, the incidence or mortality rate increased in 10 other sites, accounting for about 13% of total cancer incidence and mortality in the United States. CONCLUSIONS Overall cancer incidence and death rates continued to decline in the United States. Future progress will require sustained improvements in cancer prevention, screening, and treatment.
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Affiliation(s)
- H L Howe
- H. L. Howe, North American Association of Central Cancer Registries, Springfield, IL 62704-6495, USA.
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Cuomo L, Trivedi P, Cardillo MR, Gagliardi FM, Vecchione A, Caruso R, Calogero A, Frati L, Faggioni A, Ragona G. Human herpesvirus 6 infection in neoplastic and normal brain tissue. J Med Virol 2000. [DOI: 10.1002/1096-9071(200101)63:1<45::aid-jmv1006>3.0.co;2-k] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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