Viral Involvement in Oral Potentially Malignant Disorders: A Scoping Review

The purpose of this scoping review was to investigate which viruses other than HPV and EBV-associated with OPMDs and investigate whether viruses are linked solely to the etiology of OPMDs, their malignant transformation (MT), or both.

A scoping review following PRISMA-ScR methodological framework was used during the process. We conducted thorough searches in the EBSCOhost and PubMed databases. The inclusion criteria were publications that described viruses in OPMDs and identified pertinent research published between 2014 and 2023. The articles included underwent a thorough analysis and synthesis process to map out viruses in OPMDs. Pertinent characteristics such as research domains, publication dates, authors, type of research studies, sample sizes, gender ratios, types of OPMDs lesions, detected viruses, and methodological detection approaches were incorporated into the analysis.

A total of twenty-eight articles were eligible for inclusion. The prevalence of viruses detected in OPMDs was found to be 78.57%. Viruses detected in this study, including HPV (0% to 86.6%), EBV (8% to 95.7%), hepatitis B virus (HBV) (6.71%) and herpes simplex virus (HSV) (1%). The biggest risk factor for OPMDs found in this study was tobacco use.

Given that 90% of oral cancers worldwide are attributable to OSCC, it is crucial to understand the role of viruses such as HPV, EBV, HBV, and HSV, along with unhealthy risk factors like tobacco and alcohol, which may contribute to the etiology and progression of lesions into OPMDs. Global data indicate that these viruses play varying roles in the etiology of OPMDs, with significant geographic variability, co-infections, and interactions with lifestyle factors influencing their oncogenic potential. Although this study found that virus positivity rates were higher in the malignant stage (OSCC) than in OPMDs and that there is a high prevalence of viruses in OPMDs, further research is needed to clarify the direct causality of virus-induced malignant transformation in OPMDs.