The Role of Viruses in the Genesis of Hodgkin Lymphoma

Abstract

Hodgkin lymphoma (HL) is a heterogeneous condition. Seminal papers published in 1957 and 1966 suggested that HL in younger and older adults had different etiologies and further suggested an infectious etiology for young adult HL. Subsequent epidemiological studies provide broad support for these hypotheses. Data linking young adult HL with a high standard of living in early childhood and lack of child–child contact suggest that delayed exposure to common childhood infections may be involved in the etiology of these cases. There is now compelling evidence that a proportion of cases of HL are associated with the Epstein–Barr virus (EBV). Paradoxically, older adult and childhood cases of HL are more likely to be EBV associated than young adult cases. In this article, I will review studies on viral involvement in HL with a focus on classical HL (cHL), since nodular lymphocyte-predominant HL is considered a separate disease entity. The association with EBV will be discussed with an emphasis on findings which support a causal role for EBV in this malignancy. Studies investigating direct involvement of other exogenous viruses will be summarized.