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A Role for RNA Viruses in the Pathogenesis of Burkitt's Lymphoma: The Need for Reappraisal

DOI: 10.1155/2012/494758

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Abstract:

Certain infectious agents are associated with lymphomas, but the strength of the association varies geographically, suggesting that local environmental factors make important contributions to lymphomagenesis. Endemic Burkitt’s Lymphoma has well-defined environmental requirements making it particularly suitable for research into local environmental factors. The Epstein-Barr virus and holoendemic Malaria are recognized as important cofactors in endemic Burkitt’s Lymphoma and their contributions are discussed. Additionally, infection with Chikungunya Fever, a potentially oncogenic arbovirus, was associated with the onset of endemic Burkitt’s Lymphoma in one study and also with space-time case clusters of the lymphoma. Chikungunya Virus has several characteristics typical of oncogenic viruses. The Flavivirus, Hepatitis C, a Class 1 Human Carcinogen, closely related to the arboviruses, Yellow Fever, and Dengue, is also more distantly related to Chikungunya Virus. The mechanisms of oncogenesis believed to operate in Hepatitis C lymphomagenesis are discussed, as is their potential applicability to Chikungunya Virus. 1. Introduction It has been estimated that approximately 20% of all cancers, worldwide, are attributable to infectious agents [1]. This is likely to be an underestimate because of under-reporting and under-ascertainment, particularly in resource-poor countries, where the burden of infection-related cancers is almost four times that of the more prosperous countries [1]. A number of infectious agents, comprised of a variety of different types of organisms, have been shown to be associated with lymphomas. It is highly probable that this number will continue to expand as diagnostic methods improve, new organisms emerge and general advances in knowledge are made. Some of the organisms which have been linked with different types of lymphomas have already been designated Class 1 Human Carcinogens by the World Health Organisation. They are the DNA Herpes viruses, the Epstein-Barr virus [2] and Kaposi Sarcoma Herpesvirus [2, 3], the retroviruses Human Immunodeficiency Virus type 1 and Human T Cell Lymphotropic Virus Type 1 [4], the Hepatitis viruses, Hepatitis B, a DNA virus, and Hepatitis C, an RNA virus [5], and the bacterium, Helicobacter pylori [6]. In addition, the bacteria Campylobacter jejuni [7], Chlamydia psittaci and pneumoniae [8, 9], Borrelia burgdorferi [10, 11] and the RNA Alphavirus Chikungunya virus [12], an arbovirus, have been found to be associated with various different forms of lymphoma. The Epstein-Barr virus (EBV) [2], the protozoon,

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