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Microbes & Immunity Correlation between VZV and cancer

(OR: 1.74) and lung cancer (OR: 1.17) after adjustment for (aOR = 1.38), diffuse large B-cell lymphoma (aOR = 1.30),
risk factors. No significant associations were observed for lymphoplasmacytic lymphoma (aOR = 1.99), and chronic
localized-stage cancers. These findings require further lymphocytic leukemia/small lymphocytic lymphoma
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investigation as data on cancer stage diagnosis in VZV (aOR = 1.55). A nationwide population-based matched-
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patients is limited, and this paper serves as one of the only control study in the Taiwan region by Liu et al. found
papers investigating this topic. 103 that patients with HZ had a significantly higher risk of
developing lymphoid malignancies, with an adjusted
5.2. VZV and oropharyngeal cancer hazard ratio (HR) of 1.68 (95% CI: 1.35 – 2.42). The most
Just as other viruses of the Herpesviridae family that are common lymphoid malignancies observed were non-
able to affect the oropharynx, such as EBV’s association Hodgkin’s lymphoma and multiple myeloma. Buntinx
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with nasopharyngeal carcinoma or HSV-1’s association et al. found a significantly increased risk of developing
with esophagitis, VZV has shown some association with lymphoid malignancies, particularly Hodgkin’s disease
oropharyngeal cancer (OPC). A nationwide case–control and multiple myeloma, in the Korean population in a
study utilizing Taiwan’s Longitudinal Health Insurance retrospective cohort study reporting an adjusted hazard
Database 2010 found a significantly higher odds ratio (OR) ratio (HR) of 1.58 (95% CI: 1.23 – 2.02) for lymphoid
for HZ of OPC patients versus controls. The study reported malignancies in patients with HZ.
an odds ratio of 2.198 (95% confidence interval [CI]:
2.001 – 2.415) for head and neck cancers, including these 5.4. VZV and pulmonary cancer
specific subtypes, after adjusting for comorbidities and As stated before, VZV can spread through respiratory
risk factors. Specific OPCs found to have an elevated OR droplets when an infected person coughs, sneezes,
were oral cavity cancer, oropharynx, larynx, hypopharynx, or talks, possibly linking to lung cancer development
nasopharynx, and salivary gland cancers. Furthermore, following VZV infection. Sim et al. investigated this in
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a case–control study by Mahale et al. found a significant a nationwide population-based matched control study in
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association between HZ and an increased risk of oral South Korea, reporting that the diagnosis is most evident in
cavity/pharyngeal cancers, with an adjusted odds ratio PHN patients, with a hazard ratio (HR) of 1.65 compared
(aOR) of 1.21. Schmidt et al. further supported these to non-PHN patients. A population-based study by Chiu
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findings, reporting an RR of 1.76 (95% CI: 1.13 – 2.50). et al. found that the hazard ratio (HR) for subsequent
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With that said, population-based studies and meta-analysis cancer, particularly lung cancer, was significantly higher
which included investigations into OPC and HZ infection during the first 2 years after an initial diagnosis of HZ.
found no significant association or even a lower risk of Specifically, the HR for lung cancer was elevated within
these cancers. 11,102,104,107,108 the 1 year (HR = 1.58, 95% CI: 1.38 – 1.80) and remained
st
significant between 1 and 2 years (HR = 1.30, 95% CI: 1.15
5.3. VZV and hematological cancer – 1.46). Mahale et al. also reported a modestly increased
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Given the established links between viral diseases and risk of lung cancer associated with HZ, with an aOR of
11
hematological cancers, such as EBV’s role in Hodgkin’s 1.11. Cotton et al. also reported a significantly elevated
lymphoma, Burkitt lymphoma, and non-Hodgkin’s hazard ratio for developing lung cancer with a reported
lymphoma, there has been growing interest in investigating HR of 2.90 (95% CI: 2.23 – 3.76). Just as with OPC,
the potential association between VZV and hematological other population-based studies and meta-analyses which
cancers. Of all the meta-analysis and population-based included investigations into pulmonary cancers and HZ
studies investigating the risk of multiple cancers after infection found no significant association or even a lower
HZ infection used for this review, all of them showed risk of these cancers. 102,107,108
a significant increase in one or multiple hematologic
malignancies. 11,102,104,107,108 A longitudinal follow-up study 5.5. VZV and gastrointestinal (GI) cancer
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in the Korean population by Choi et al. reported an The enteric nervous system (ENS) plays a crucial role in
increased risk of lymphoid neoplasms in patients with HZ, regulating GI function, and growing evidence suggests that
with an adjusted HR of 1.58 (95% CI: 1.23 – 2.02). This VZV can infect and establish latency in enteric neurons,
study also found that the risks of Hodgkin’s disease and similar to its behavior in sensory neurons. One of the
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multiple myeloma/malignant plasma cell neoplasms were earliest population-based cohort studies investigating
significantly elevated in patients with HZ. In addition, a the link between VZV and an increased risk of cancer
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case–control study in the U.S. elderly population by Mahale was conducted in 1982. Although limited by sample
et al. identified significant associations between HZ and size, the study reported a modestly elevated RR of 1.1 for
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various hematologic malignancies, including myeloma colon and bladder tumors in women. Schmidt et al. also
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Volume 2 Issue 3 (2025) 23 doi: 10.36922/mi.8320