No Serological Evidence of Association between Prostate Cancer and Infection with Herpes Simplex Virus Type 2 or Human Herpesvirus Type 8: A
Department of Medical Microbiology, Lund University, University Hospital, Malm, Sweden
Microbiology-Immunology and Virology Department, Centro di Rihiurerimento Oncologico Aviano, Italy
National Public Health Institute, Helsinki, Finland
Sexual history has consistently been found to be a risk factor for the development of prostate cancer. An association between prostate cancer and herpes simplex virus type 2 (HSV-2) or Kaposi sarcomaassociated herpesvirus/human herpesvirus type 8 (HHV-8) infections has also been reported. Linkage of data on a cohort of 20,243 healthy Finnish men identified 165 cases of prostate cancer that were diagnosed up to 24 years after donation of a serum sample. Two control subjects were matched by age, sex, and municipality of residence to each case patient. Serum levels of immunoglobulin G against HSV-2 and HHV-8 were determined. Neither HSV-2 infection (odds ratio [OR], 0.93 [95% confidence interval {CI}, 0.441.96]) nor HHV-8 infection (OR, 0.74 [95% CI, 0.192.88]) was associated with prostate cancer.
Sexual history and sexually transmitted infections (STIs) have consistently been found to be risk factors in the etiology of prostate cancer [1]. Direct evidence of the involvement of an infectious agent in prostate cancer has been sought for many years.
Human papillomavirus (HPV)in particular, types 16 and 18is recognized as the primary cause of intraepithelial neoplasias of the anogenital tract, which are precursor lesions of anogenital cancers (most notably cervical cancer) [2]. Although several studies have found an association between HPV infection and prostate cancer, the association has not been consistently found [3, 4].
Herpes simplex virus type 2 (HSV-2) has been reported to infect prostate tissue [5]. However, there are technical difficulties in conducting virus detection studies. Furthermore, these studies typically lack control samples of prostate tissue from healthy persons. Serological studies may be preferable for studying the possible association between infectious agents and prostate cancer, because serum samples can be easily obtained from both case patients and healthy control subjects and because serological markers for past or present infection exist. Seroprevalences of pathogens that cause STIs are also commonly used as objective markers of sexual history in populations [6]. An increase in HSV-2 antibodies in patients with prostate cancer has been reported in several studies [7].
Kaposi sarcomaassociated herpesvirus/human herpesvirus type 8 (HHV-8)which is the cause of Kaposi sarcoma, primary effusion lymphoma, and multicentric Castleman disease [8]has been reported to be present in prostate tissue [9]. HHV-8 is transmitted through sexual intercourse, but it may also have other modes of transmission [6]. A recent case-control study performed in both the United States and Tobago reported a highly significant association between prostate cancer and HHV-8 seropositivity (odds ratio [OR], 2.24 [95% confidence interval {CI}, 1.33.9] in Tobago; OR, 4.67 [95% CI, 1.911.6] in the United States) [10]. However, case-control studies may be subject to selection biases and reverse causality biases, and it is therefore important to investigate the consistency of this association using studies that have strong epidemiological designs. In the present study, we report results from a prospective and population-based nested case-control study of prostate cancer risk in relation to HSV-2 and HHV-8 infection assessed by serological methods.
Materials and methods.
Between 1968 and 1972, the Mobile Clinic of the Social Insurance Institution of Finland performed a health screening examinationwhich included a health interview (including questions about marital status and smoking status), some routine physiological measurements (such as bo
Microbiology-Immunology and Virology Department, Centro di Rihiurerimento Oncologico Aviano, Italy
National Public Health Institute, Helsinki, Finland
Sexual history has consistently been found to be a risk factor for the development of prostate cancer. An association between prostate cancer and herpes simplex virus type 2 (HSV-2) or Kaposi sarcomaassociated herpesvirus/human herpesvirus type 8 (HHV-8) infections has also been reported. Linkage of data on a cohort of 20,243 healthy Finnish men identified 165 cases of prostate cancer that were diagnosed up to 24 years after donation of a serum sample. Two control subjects were matched by age, sex, and municipality of residence to each case patient. Serum levels of immunoglobulin G against HSV-2 and HHV-8 were determined. Neither HSV-2 infection (odds ratio [OR], 0.93 [95% confidence interval {CI}, 0.441.96]) nor HHV-8 infection (OR, 0.74 [95% CI, 0.192.88]) was associated with prostate cancer.
Sexual history and sexually transmitted infections (STIs) have consistently been found to be risk factors in the etiology of prostate cancer [1]. Direct evidence of the involvement of an infectious agent in prostate cancer has been sought for many years.
Human papillomavirus (HPV)in particular, types 16 and 18is recognized as the primary cause of intraepithelial neoplasias of the anogenital tract, which are precursor lesions of anogenital cancers (most notably cervical cancer) [2]. Although several studies have found an association between HPV infection and prostate cancer, the association has not been consistently found [3, 4].
Herpes simplex virus type 2 (HSV-2) has been reported to infect prostate tissue [5]. However, there are technical difficulties in conducting virus detection studies. Furthermore, these studies typically lack control samples of prostate tissue from healthy persons. Serological studies may be preferable for studying the possible association between infectious agents and prostate cancer, because serum samples can be easily obtained from both case patients and healthy control subjects and because serological markers for past or present infection exist. Seroprevalences of pathogens that cause STIs are also commonly used as objective markers of sexual history in populations [6]. An increase in HSV-2 antibodies in patients with prostate cancer has been reported in several studies [7].
Kaposi sarcomaassociated herpesvirus/human herpesvirus type 8 (HHV-8)which is the cause of Kaposi sarcoma, primary effusion lymphoma, and multicentric Castleman disease [8]has been reported to be present in prostate tissue [9]. HHV-8 is transmitted through sexual intercourse, but it may also have other modes of transmission [6]. A recent case-control study performed in both the United States and Tobago reported a highly significant association between prostate cancer and HHV-8 seropositivity (odds ratio [OR], 2.24 [95% confidence interval {CI}, 1.33.9] in Tobago; OR, 4.67 [95% CI, 1.911.6] in the United States) [10]. However, case-control studies may be subject to selection biases and reverse causality biases, and it is therefore important to investigate the consistency of this association using studies that have strong epidemiological designs. In the present study, we report results from a prospective and population-based nested case-control study of prostate cancer risk in relation to HSV-2 and HHV-8 infection assessed by serological methods.
Materials and methods.
Between 1968 and 1972, the Mobile Clinic of the Social Insurance Institution of Finland performed a health screening examinationwhich included a health interview (including questions about marital status and smoking status), some routine physiological measurements (such as bo