Oncogenic viruses

Overview

• HPV vaccination (Gardasil 9) and HBV vaccination prevent the infection; HCV direct-acting antivirals and H. pylori eradication remove the driver
• HPV testing and colposcopy find and excise precursor lesions
• Checkpoint inhibitors work well in Merkel cell (avelumab, retifanlimab) and HPV+ cancers; EBV- and HPV-specific TCR-T and vaccines are in trials
• Plasma EBV DNA screens for nasopharyngeal carcinoma and tracks response

• Lymphoma: two viruses, two mechanisms. Epstein-Barr virus causes different diseases depending on which latency programme the infected cell runs, from EBNA1 alone in Burkitt lymphoma to the full set in post-transplant disease, and the programme tracks how closely T cells are watching (Young and Rickinson 2004). HTLV-1 works by starting a process the host genome then finishes along the lines the virus drew: across 426 adult T-cell leukaemia/lymphoma cases, the acquired alterations overlapped significantly with the Tax interactome and concentrated in T-cell receptor and NF-kB signalling, trafficking and immune surveillance (Kataoka 2015).