Association of Herpes simplex infection with significantly increased risk of head and neck cancer: real-world evidence of about 500,000 patients

Jennifer von Stebut; Max Heiland; Robert Preissner; Carsten Rendenbach; Saskia Preissner

doi:10.1111/ijd.17196

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. 2024 Apr 21. doi: 10.1111/ijd.17196. Online ahead of print.

Authors

Jennifer von Stebut¹, Max Heiland¹, Robert Preissner², Carsten Rendenbach¹, Saskia Preissner¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
² Structural Bioinformatics Group, Science-IT and Institute for Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

PMID: 38643367
DOI: 10.1111/ijd.17196

Abstract

Background: The role of viral agents in the development of head and neck cancers has remained controversial. While markers of viral origin have been isolated from oral cancer tissues, a causative relationship has yet to be shown. The aim of this study was to evaluate the relationship between head and neck cancers and Herpes simplex virus, one of the most common viral infections of the oral orifice.

Methods: Here, we 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). The diagnoses C00-C14 were analyzed, and risk analysis and Kaplan-Meier survival statics were computed.

Results: The strongest association was found for lip cancer (ICD-10: C00) with a hazard ratio [HR (CI 95% low-high)] of 3.08 (1.77-5.35). 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.

Conclusion: The 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.

Keywords: HSV; head and neck cancer; herpes simplex virus; lip cancer; real‐world data.

Grants and funding

RE-4803/1-1/German Research Foundation