Oncoviruses in the Oral Cavity: Recent Advances in Understanding Viral Infections and Tumorigenesis

Abstract

Oncoviruses, such as Epstein-Barr virus (EBV), human papillomavirus (HPV), and Kaposi sarcoma-associated herpesvirus (KSHV), have been widely discussed for their oncogenic risk. Initially, the oral cavity was disregarded. In recent years, orientation has shifted to the importance of the oral cavity and cancer-related issues via Handbook 19 titled "Oral Cancer Prevention" by the International Agency for Research on Cancer, the WHO Global Oral Health Status Report 2022, and multiple other actions focused on reducing the oversight of this neglected area. Oncoviruses play a significant role in oral cavity malignancies by establishing persistent infections, evading host immune responses, and inducing cellular transformation through the disruption of normal regulatory pathways. Molecular biology and microbiome research have advanced our understanding of the complex interplay between oncoviruses and oral microbiota, demonstrating how coinfections and dysbiosis can enhance viral oncogenic potential. These findings improve the understanding of virus-induced oral cancers and support the development of novel diagnostic and therapeutic strategies. This narrative review focuses on the relationship between oncoviruses and the oral cavity by focusing on how a specific virus triggers tumorigenesis for each of the described viruses and how it affects oral cavity cancer development. Finally, we describe recent advances and future perspectives including vaccines and/or treatment.

Keywords: oral cancer; oral oncoviruses; viral tumorigenesis.

Figure 1

Mechanisms of viral tumorigenesis: Diagram illustrating the different mechanisms by which oncogenic viruses contribute to cancer development. The processes include chronic inflammation, inactivation of tumor suppressor proteins, integration of the viral genome into the host DNA, oxidative stress, metabolic changes, and immunosuppression.