Epstein-Barr Virus and Nasopharyngeal Carcinoma: A Review on Virology, Oncogenic Mechanisms, and Clinical Implications

Abstract

Epstein-Barr virus (EBV) is a ubiquitous human gammaherpesvirus with the unique ability to establish lifelong latency and drive oncogenic transformation in several malignancies, including nasopharyngeal carcinoma (NPC). This review summarizes the essential virology of EBV, highlighting its structural components, infection mechanisms, and latent gene expression programs that facilitate immune evasion and cellular transformation. A strong epidemiological and molecular correlation exists between EBV infection and the development of NPC, particularly in endemic regions. EBV exhibits a tropism for epithelial cells lining the nasopharynx, where it invades through receptor-mediated entry and establishes latent infection. Key viral oncogenes such as latent membrane protein 1 (LMP1), LMP2, and EBNA1 activate multiple oncogenic pathways including NF-κB, JAK/STAT, PI3K/AKT, and MAPK, promoting proliferation, resistance to apoptosis, and genomic instability. Additional biomarkers such as circulating EBV DNA and serological antibodies offer diagnostic and prognostic value. The review also outlines the current staging system for NPC, which guides clinical management and treatment decisions. Understanding the interplay between EBV virology, host immune responses, and molecular drivers provides critical insights into NPC pathogenesis and highlights potential targets for early detection, prevention, and therapeutic intervention.