Human papilloma virus, herpes simplex virus and epstein barr virus in oral squamous cell carcinoma from eight different countries

Research output: Contribution to journalArticle


Oral squamous cell carcinoma (OSCC) is a major health problem in many parts of the world, and the major causative agents are thought to be the use of alcohol and tobacco. Oncogenic viruses have also been suggested to be involved in OSCC development. This study investigated the prevalence of human papillomaviruses (HPV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) in 155 OSCC from eight different countries from different ethnic groups, continents and with different socioeconomic backgrounds. 41 A total of OSCCs were diagnosed in the tongue (26%) and 23 in the floor of the mouth (15%); the other 91 OSCCs were diagnosed in other locations (59%). The patients were also investigated regarding the use of alcohol and smoking and smokeless tobacco habits. Tissue samples were obtained from formalin-fixed, paraffin-embedded samples of the OSCC. DNA was extracted and the viral genome was examined by single, nested and semi-nested PCR assays. Sequencing of double-stranded DNA from the PCR product was carried out. Following sequencing of the HPV-, HSV- and EBV-positive PCR products, 100% homology between the sampels was found. Of all the 155 OSCCs examined, 85 (55%) were positive for EBV, 54 (35%) for HPV and 24 (15%) for HSV. The highest prevalence of HPV was seen in Sudan (65%), while HSV (55%) and EBV (80%) were most prevalent in the UK. In 34% (52/155) of all the samples examined, co-infection by two (46/155=30%) or three (6/155=4%) virus specimens was detected. The most frequent double infection was HPV with EBV in 21% (32/155) of all OSCCs. There was a statistically significant higher proportion of samples with HSV (p=0.026) and EBV (p=0.015) in industrialized countries (Sweden, Norway, UK and USA) as compared to developing countries (Sudan, India, Sri Lanka and Yemen). Furthermore, there was a statistically significant higher co-infection of HSV and EBV in samples from industrialized countries (p=0.00031). No firm conclusions could be drawn regarding the relationship between alcohol, tobacco and virus infections. The significance of our findings must be put in relation to other risk factors and these observations warrant further studies to determine the possible role of viral infections and co-infections with HPV, EBV and HSV as risk markers for the development of OSCC.


  • Jamshid Jalouli
  • Miranda M Jalouli
  • Dipak Sapkota
  • Salah O Ibrahim
  • Per-Anders Larsson
  • Lars Sand
External organisations
  • Helsingborg Hospital
Research areas and keywords


  • Adult, Africa, Aged, Aged, 80 and over, Alcohol Drinking, Animals, Asia, Base Sequence, Carcinoma, Squamous Cell, Cercopithecus aethiops, DNA, Viral, Epstein-Barr Virus Infections, Europe, Herpes Simplex, Herpesvirus 4, Human, Humans, Middle Aged, Molecular Sequence Data, Mouth Neoplasms, North America, Papillomaviridae, Papillomavirus Infections, Prevalence, Simplexvirus, Smoking, Tobacco, Smokeless, Journal Article
Original languageEnglish
Pages (from-to)571-80
Number of pages10
JournalAnticancer research
Issue number2
Publication statusPublished - 2012 Feb
Publication categoryResearch
Externally publishedYes