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Article Open Access

Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population

  • Authors:
    • Janpen Bamrungthai
    • Tipaya Ekalaksananan
    • Sutida Pongpakdeesakul
    • Theeradon Rueankaew
    • Wanpiya Fhakdee
    • Darin Duangchai
    • Fernladda Kattiwong
    • Pornsiri Lanpol
    • Sasiwimon Sumala
    • Kachain Chantawong
    • Sureewan Duangjit
    • Sureewan Bumrungthai
    • Chamsai Pientong
  • View Affiliations / Copyright

    Affiliations: Department of Otorhinolaryngology, Sunpasitthiprasong Hospital, Maung Ubon Ratchathani, Ubon Ratchathani 34000, Thailand, Department of Microbiology, Faculty of Medicine, Khon Kaen University, Mueang Khon Kaen, Khon Kaen 40002, Thailand, Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Maung Phayao, Phayao 56000, Thailand, Division of Biopharmacy, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Maung Ubon Ratchathani, Ubon Ratchathani 34190, Thailand, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Maung Ubon Ratchathani, Ubon Ratchathani 34190, Thailand
    Copyright: © Bamrungthai et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 50
    |
    Published online on: February 20, 2026
       https://doi.org/10.3892/br.2026.2123
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Abstract

Current data on the genetic and lifestyle factors associated with Epstein‑Barr virus (EBV) reactivation in the oral cavity are limited for the Thai population. Furthermore, comprehensive data linking EBV reactivation to head and neck cancers in Thailand remains scarce. The present study aimed to detect EBV reactivation using quantitative PCR in normal oral buccal cells and to examine the associated risk factors. A total of 982 oral buccal cell samples collected across Thailand were analyzed. EBV was detected in 36% (350/974) of samples when targeting the Epstein‑Barr nuclear antigen‑1 gene, 52% (458/885) of samples when targeting latent membrane protein‑1 (LMP‑1) and 20% (196/981) of samples when both genes were investigated. The highest prevalence of LMP‑1 and dual gene positivity was observed in individuals aged 11‑20 years. Several SNPs in the TNF‑α promoter region, including rs1452146766, rs1799964, rs1554283139, rs924800313, rs1799724 and rs1771099055, were more frequently observed in EBV‑positive samples than in EBV‑negative samples. Notably, the TNF‑α mutation rs1799964 (‑1031 TC and CC) was present in 17.3% vs. 9.3% of EBV‑positive cases, respectively. Multivariate analysis identified sex, smoking, alcohol consumption, soft drink intake, age of 21‑30 years and having four children as significant factors associated with EBV reactivation. In the 21‑30‑year‑old age group, LMP‑1 positivity was elevated, and higher rates of alcohol use, sexual activity and oral ulcers were observed. Furthermore, in individuals with mouth ulcers, the TNF‑α mutation (TC; n=81) was more common than wild‑type TNF‑α (CC; n=16).
View Figures

Figure 1

Association between TNF-α
(-1031 TC) and dual gene positivity (both positive EBNA-1
and LMP-1). EBNA-1, Epstein-Barr nuclear antigen-1;
EBV, Epstein-Barr virus; LMP-1, latent membrane
protein-1.

Figure 2

Multivariate binary logistic
regression models showing associations between Epstein-Barr virus
reactivation (EBNA-1 and/or LMP-1) and risk factors.
The x-axis represents ORs and the y-axis lists risk factors. (A)
EBNA-1 status, (B) LMP-1 status and (C) dual gene
positivity. *Statistically significant. EBNA-1,
Epstein-Barr nuclear antigen-1; LMP-1, latent membrane
protein-1; OR, odds ratio.

Figure 3

Exposure to risk factors of oral
cancer across age groups. Colors represent the range percentage of
exposure to environmental risk factors: 0-20%, green; 21-40%, blue;
41-60%, orange; 61-80%, red; 81-100%, yellow. Lighter colors and
darker colors indicate lower and higher percentages, respectively
(Table SII). Factors included
Epstein-Barr virus status, sex, congenital disease, mouth ulcers,
family history of cancer, smoking and sexual activity.
EBNA-1, Epstein-Barr nuclear antigen-1; LMP-1, latent
membrane protein-1.

Figure 4

TNF-α promoter mutations
detected in Epstein-Barr virus-positive samples. Red boxes indicate
the locations of point mutations. Different rows correspond to
different samples.
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Copy and paste a formatted citation
Spandidos Publications style
Bamrungthai J, Ekalaksananan T, Pongpakdeesakul S, Rueankaew T, Fhakdee W, Duangchai D, Kattiwong F, Lanpol P, Sumala S, Chantawong K, Chantawong K, et al: Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population. Biomed Rep 24: 50, 2026.
APA
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D. ... Pientong, C. (2026). Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population. Biomedical Reports, 24, 50. https://doi.org/10.3892/br.2026.2123
MLA
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D., Kattiwong, F., Lanpol, P., Sumala, S., Chantawong, K., Duangjit, S., Bumrungthai, S., Pientong, C."Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population". Biomedical Reports 24.4 (2026): 50.
Chicago
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D., Kattiwong, F., Lanpol, P., Sumala, S., Chantawong, K., Duangjit, S., Bumrungthai, S., Pientong, C."Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population". Biomedical Reports 24, no. 4 (2026): 50. https://doi.org/10.3892/br.2026.2123
Copy and paste a formatted citation
x
Spandidos Publications style
Bamrungthai J, Ekalaksananan T, Pongpakdeesakul S, Rueankaew T, Fhakdee W, Duangchai D, Kattiwong F, Lanpol P, Sumala S, Chantawong K, Chantawong K, et al: Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population. Biomed Rep 24: 50, 2026.
APA
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D. ... Pientong, C. (2026). Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population. Biomedical Reports, 24, 50. https://doi.org/10.3892/br.2026.2123
MLA
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D., Kattiwong, F., Lanpol, P., Sumala, S., Chantawong, K., Duangjit, S., Bumrungthai, S., Pientong, C."Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population". Biomedical Reports 24.4 (2026): 50.
Chicago
Bamrungthai, J., Ekalaksananan, T., Pongpakdeesakul, S., Rueankaew, T., Fhakdee, W., Duangchai, D., Kattiwong, F., Lanpol, P., Sumala, S., Chantawong, K., Duangjit, S., Bumrungthai, S., Pientong, C."Investigation of genetic and lifestyle risk factors associated with Epstein‑Barr virus reactivation in the Thai population". Biomedical Reports 24, no. 4 (2026): 50. https://doi.org/10.3892/br.2026.2123
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