EBV and cancer

Electronmicroscope image of Eppstein Bar Virus

What is EBV?

EBV, or Epstein-Barr virus, is spread through saliva and infection is very common – more than 9 in 10 people are infected worldwide. The virus infects a type of cell called ‘B-cells’, that form part of the immune system – the body’s defence against disease.

Most people get EBV as children and will not experience any symptoms. But if people pick up the infection when they are older, they can develop glandular fever (sometimes called ‘mono’ or ‘kissing disease’) as a result.

While glandular fever can be very unpleasant, it usually passes within a few weeks. Once infected, a person remains a carrier of EBV for life, but the virus normally doesn’t cause any symptoms at all.

What cancers are linked to EBV?

In rare cases, infection with EBV can be linked to cancer, including Hodgkin lymphoma, naso-pharyngeal cancer (a type of head and neck cancer) and Burkitts lymphoma.

Just under half of all Hodgkin lymphoma cases in the UK are linked to EBV infection. And it is estimated that EBV infections can be found in 9 in 10 people with naso-pharyngeal cancer in the UK. But this doesn’t necessarily mean that the cancer was caused by the infection.

Burkitts lymphoma is a type of Non-Hodgkin lymphoma and it is very rare in the UK. 1 in 4 cases of Burkitts lymphoma are linked to EBV infection.

How can EBV cause cancer?

Usually the EBV virus will not cause any symptoms at all. But we still don’t know for sure why some people develop cancer years after being infected with EBV. In some infected B-cells the virus may switch off normal processes that control cell growth, causing them to grow and divide out of control. But this doesn’t happen in everyone, and it’s likely that other factors also play a role in whether or not cancer develops.

Reducing the risk

Most people get infected with EBV as a child and stay infected for life without ever experiencing any symptoms. That’s why reducing the risk of EBV linked cancers is difficult, because most people are infected without knowing it, and we can’t predict who will develop cancer and who won’t.

Some researchers think that the best way forward would be to develop a vaccine that can either prevent the initial infection, or at least stop EBV linked cancers developing. We don’t have a vaccine to do this yet. To promote research in this area, Cancer Research UK has made the eradication of EBV linked cancers one of its Grand Challenges.

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