Beyond Human Papillomavirus (HPV): Detection of EBV and Polyomaviruses in Cervical and Anal Samples

Colorectal and cervical cancers represent an important public health problem worldwide, particularly in Brazil. Colorectal cancer is one of the most frequently diagnosed malignancies worldwide and the most common cancer in both men and woman in Brazil. Although cervical cancer also remains a significant public health concern in the female population due to its high incidence and mortality rates. Epstein-Barr virus (EBV), and Polyomaviruses (JCPyV and BKPyV) are considered as oncoviruses with a prevalence of 90% in the adult population. Studies suggest that coinfection with Human papillomavirus (HPV) and EBV, JCPyV and BKPyV can be associated with anal cancer, with HPV being the dominant viral cause. Although in cervical cancer, this coinfection is often observed, and it may enhance cervical oncogenic potential. These facts are particularly concerning in women living with HIV, who are more susceptible to persistent HPV infections and HPV-related cancers. This study aimed to investigate EBV, JCPyV and BKPyV presence in HPV-infected women living with HIV. This cross-sectional study collected 33 cervical and 30 anal scrapings samples, as well as 26 paired samples from both sites from HPV-positive women living with HIV. Viral detection and quantification for EBV, JCPyV and BKPyV were performed using real-time polymerase chain reaction (qPCR), while HPV detection and genotyping utilized the Novaplex^TM assay. EBV was detected in 33.3% of anal scraping and 21.2% in cervical scraping. HPV 51 and HPV 56 were most frequently detected in anal and cervical scrapings, respectively. The EBV mean viral load was higher in cervical scraping (2.27 × 10^5 copies/mL) when compared to anal scraping (1.19 × 10^5 copies/mL) in relation of JCPyV and BKPyV viral loads. Regarding coinfections, it was found that EBV presented a high coinfection rate with high-risk HPV genotypes (hrHPV) (14.6%) with HPV 31 in both samples. This study provided valuable data about the frequency of EBV in anal and cervical HPV-positive women. The elevated viral load of EBV in cervical scrapings may suggest a potential role in modulating the local microenvironment and warrants further investigation into the synergistic effects of EBV and HPV in anogenital and cervical carcinogenesis. Overall, the results of this study emphasize the need for further investigation into the role of these viruses in the progression of cervical lesions.