EBV-Related Malignancies, Outcomes and Novel Prevention Strategies

Background: Epstein Barr Virus (EBV) is a common gamma herpes virus with a high prevalence in adults worldwide. Infection is mostly latent in affected individuals. EBV has been linked mostly with lymphoid malignancies but its association with epithelial and other non-lymphoid malignancies has also been described. Methods: Using MEDLINE, the terms “Epstein Barr Virus AND Malignancy”; “EBV mechanisms”; EBV treatment AND outcomes”; and “EBV prevention” were combined to find articles pertinent to this review. The search was limited to more recent publications between January 1, 2000 and August 1, 2015. Results: In this review, we describe current knowledge about the pathogenesis of EBV-related malignancies and evaluate their therapeutic options and outcomes. Current and prospective novel preventive options are also critically reviewed. Conclusions: EBV infection is a very common viral infection worldwide and has been implicated in various malignancies including lymphomas, gastric cancer, and nasopharangeal cancer. Patients with EBV positive PTLD and NK/T-cell lymphoma tend to have a better prognosis than EBV negative patients. On the other hand, patients with EBV positive HL or DLBCL tend to have a poorer prognosis especially in elderly patients. Further research is needed to better understand if EBV status is a true prognostic indicator in most malignancies. Treatment approaches remain similar for EBV positive and EBV negative malignancies while the use of novel agents remain under investigation. EBV vaccination trials are underway and these remain a potentially effective strategy to prevent EBV-related malignancies and the associated sequela.