Association of EBV infection with increased cancer aggressiveness in prostate cancer patients: A systematic review and meta-analysis

Syed Hani Abidi, Olaoluwa Tolulope Fabiyi, Zhannur Omarova, Alisalman Sheikh, Khalid Ahmed, Ram Chandra Bajpai

2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.17219/acem/218967
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

BACKGROUND: Several studies have reported the presence of Epstein-Barr virus (EBV) in prostate carcinoma tissues and have investigated how EBV might contribute to prostate cancer (PCa) development. To the best of our knowledge, no comprehensive systematic review and meta-analysis have been performed to: 1) estimate the pooled prevalence of EBV in PCa, particularly in samples with high and low Gleason scores; and 2) examine the association between EBV and PCa aggressiveness, measured using high-grade and/or Gleason scores. OBJECTIVES: This study aimed to achieve 2 primary objectives: 1) to estimate the pooled prevalence of EBV in PCa; and 2) to determine the association between EBV infection and cancer aggressiveness, specifically in relation to moderate-to-high Gleason scores (7 and above). MATERIAL AND METHODS: PubMed, Embase, and Google Scholar were systematically searched for relevant observational studies on EBV and PCa from database inception through December 31, 2024. The quality of the studies was assessed using the JBI criteria based on study design. A meta-analysis was conducted using 9 and 4 studies, respectively, to estimate the pooled EBV prevalence and the association between EBV infection and Gleason scores, along with 95% confidence and prediction intervals. RESULTS: A total of 9 studies were included in the analysis. The pooled EBV prevalence among 927 PCa samples was estimated at 33% (95% confidence interval (95% CI): 16-52%; I2 = 94.17%), while EBV prevalence in PCa samples with moderate-to-high (≥7) and low (6) Gleason scores was 59% (95% CI: 21-92%; I2 = 90.86%) and 34% (95% CI: 15-56%; I2 = 0.00%), respectively. Similarly, EBV presence in PCa samples was associated with increased odds of moderate-to-high Gleason scores (odds ratio (OR) = 2.38, 95% CI: 1.82-3.13, I2 = 0.00%, p = 0.002). CONCLUSION: This study highlights EBV as a possible risk factor for aggressive prostate cancer (PCa). Additional research is necessary to explore how EBV proteins contribute to PCa development.