Herpes simplex (HSV) and head and neck cancer

A small study concluded that herpes simplex virus-1 (HSV-1) is a possible etiological factor in the causation of oral cancer and precancer (1)

• results were consistent with the hypothesis that cancer of the oral cavity is associated with expression of HSV-1 antigen that stimulates IgG antibody response

A subsequent much larger study has revealed the association between herpes simplex virus (HSV) infection and an elevated risk for head and neck cancer, particularly lip cancer (2):

• investigators conducted a retrospective analysis of two age- and gender-matched cohorts extracted from the real-world database TriNetX on March 10th, 2023, each consisting of 249,272 patients with and without Herpes simplex infections (ICD-10: B00)
  • diagnoses C00-C14 were analyzed, and risk analysis and Kaplan-Meier survival statics were computed
• strongest association was found for lip cancer. A significant association with HR of 1.17 (1.02–1.34) was found for the entire group of head and neck cancers. Confounders like smoking and alcohol dependence were considered using propensity score matching
  • incidence of head and neck cancer was low overall but higher among patients with vs without HSV infection (0.002% vs 0.001%; P < .0001)
    • difference translated to a significant increase in the risk for the group with HSV infection (hazard ratio, 1.17)
  • elevated risk was mainly driven by a sharply higher risk for lip cancer (hazard ratio, 3.08)
    • when location on the lip was considered (outer vs inner aspect), HSV infection conferred a significantly elevated risk only for cancers of the outer aspect (odds ratio, 2.47), suggesting a possible added role for ultraviolet light exposure
• study authors concluded :
  • surprisingly strong correlation with lip, oral cavity, and pharynx neoplasms sheds new light on supposedly harmless herpes simplex infections, suggesting them as a possible new factor for risk stratification

Reference:

1. Jain M. Assesment of Correlation of Herpes Simplex Virus-1 with Oral Cancer and Precancer- A Comparative Study. J Clin Diagn Res. 2016 Aug;10(8):ZC14-7. doi: 10.7860/JCDR/2016/18593.8229.
2. von Stebut, J., Heiland, M., Preissner, R., Rendenbach, C. and Preissner, S. (2024), Association of Herpes simplex infection with significantly increased risk of head and neck cancer: real-world evidence of about 500,000 patients. Int J Dermatol. https://doi.org/10.1111/ijd.17196