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Microbes & Immunity

REVIEW ARTICLE
Correlation between varicella-zoster virus

infection and cancer development: A
comprehensive analysis

Fernando Cisneros IV, Blake Martin, and Shizue Mito*

Department of Medical Education, School of Medicine, The University of Texas Rio Grande Valley,
Edinburg, Texas, United States of America

Abstract

Varicella-zoster virus (VZV) is a highly prevalent pathogen primarily recognized for
causing chickenpox during primary infection, and herpes zoster (HZ), also known
as shingles, upon reactivation. While post-infectious complications of VZV, such as
encephalitis, pneumonia, and post-herpetic neuralgia, are well-established, recent
large population-based studies suggest that HZ may increase the risk of occult
cancers. This has sparked discussions on the need for cancer screening in patients
with HZ to improve early diagnosis and prognosis. However, the specific types of
cancers most strongly associated with VZV reactivation have not been systematically
identified, and the subsequent cancer risk remains inconclusive. Emerging evidence
suggests that VZV may also modulate key oncogenic pathways, such as the inhibition
of apoptosis, alteration of cell cycle regulatory enzymes, and interference with
*Corresponding author: immunosurveillance, which could potentially promote cancer development. These
Shizue Mito findings indicate that VZV’s role in cancer biology extends beyond merely increasing
(shizue.mito@utrgv.edu) cancer risk and may involve direct cellular manipulation that facilitates oncogenesis.
Citation: Cisneros IV F, Martin B, Understanding the interplay between VZV and cancer is critical for public health.
Mito S. Correlation between Further exploration of the mechanisms of viral oncogenesis could provide valuable
varicella-zoster virus infection
and cancer development: A insights into how VZV contributes to cancer development and open avenues for
comprehensive analysis. Microbes targeted preventive and therapeutic strategies.
& Immunity. 2025;2(3):15-30.
doi: 10.36922/mi.8320
Keywords: Varicella-zoster virus; Herpes zoster; Post-herpetic neuralgia; Cancer;
Received: December 31, 2024
Apoptosis; Cell cycle regulatory enzymes; Immunosurveillance; Oncogenesis
Revised: April 9, 2025
Accepted: April 9, 2025
Published online: May 2, 2025 1. Introduction
Copyright: © 2025 Author(s).
This is an Open-Access article Varicella-zoster virus (VZV), a member of the DNA virus family Herpesviridae, is a
distributed under the terms of the highly prevalent pathogen primarily recognized for causing chickenpox during primary
Creative Commons Attribution infection and shingles, also known as herpes zoster (HZ) upon reactivation. Chickenpox
1
License, permitting distribution,
and reproduction in any medium, is a common, self-limiting childhood disease characterized by a vesicular rash and fever,
provided the original work is whereas HZ occurs later in life when the virus reactivates, often following periods of
properly cited. immunosuppression. Beyond these well-known presentations, VZV is associated with
2
Publisher’s Note: AccScience a range of post-infectious complications. Neurological conditions such as encephalitis
Publishing remains neutral with and cerebellar ataxia, respiratory issues such as varicella pneumonia, and chronic pain
regard to jurisdictional claims in
published maps and institutional syndromes, including post-herpetic neuralgia (PHN), are well-documented in the
affiliations. medical literature. These complications not only contribute significantly to the disease

Volume 2 Issue 3 (2025) 15 doi: 10.36922/mi.8320