Dual Epstein-Barr virus and High-Risk Human Papillomavirus infection potentially promotes the occurrence of cervical abnormalities in women living in Southern Morocco

Abstract

Objectives: The aim of this study was to investigate whether Epstein-Barr virus (EBV) acts as a cofactor with Human Papillomavirus (HPV) in the development of cervical abnormalities among women from Southern Morocco. Methods: A total of n = 308 sexually active women were enrolled in this study. EBV and HPV were detected using a nested PCR assay. HPV genotyping was carried out using direct Sanger sequencing assay. Statistical analyses were performed using R/RStudio software. Results: EBV DNA was detected in 11.04 % of participants. Among these women, 5.84 % were co-infected with HPV and EBV, representing 53 % of women who tested positive for EBV. High-risk HPV genotypes (HR-HPV) were the most common types of dual infections, accounting for 38 % of EBV-positive cases, whereas other genotypes were detected along with EBV in 15 % of cases. Interestingly, a statistically significant association between EBV/HR-HPV and cervical abnormalities was observed in this study (OR 4.58, 95 % CI 1.97–10.60, p = 0.030). In particular, EBV/HR-HPV dual infection was associated with a 7.86-fold increased risk of developing ASCUS-type cervical lesions (OR 7.86, 95 % CI 1.08–37.92, p = 0.017). Moreover, women with several sexual partners were 3.63-folds at a greater risk of contracting an EBV/HR-HPV coinfection (OR 3.63, 95 % CI 0.92–12.32, p = 0.045). Conclusion: Our findings suggest that EBV infection alone might not directly promote cervical oncogenesis. However, the possibility of its involvement in coinfection with HR-HPV genotypes remains an area of interest. Further investigations are required to provide firm evidence of the role of EBV in this context.

Keywords

• Dual infection
• Cervical abnormalities
• EBV
• HPV
• Morocco