NCM 2022: The distribution and genetic variations of Epstein–Barr virus in sub-Saharan Africa

Epstein–Barr virus (EBV) infects most of the world’s population and underlies around 1% of all cancers, including endemic Burkitt lymphoma (eBL), a prevalent pediatric cancer in sub-Saharan Africa. Its natural history and role of viral variation are not well understood. Thus, EBV types and genetic variants were explored in the saliva of healthy Kenyans compared with isolates from individuals with eBL. Long-read nanopore sequencing of key genes central to transformation was performed for a complete description of complex insertions and deletions within the repeat regions. Within the population, we observed more EBV type 1 (70.7%) than type 2 (29.3%). Type 1 had a greater average number of LMP1 (p<0.008) and EBNA3C variants (p<0.02), and two intertypic genomes were identified. Future studies may harness this sensitive, robust method to study viral variations on more eBL and healthy individuals and other EBV-associated cancers in Africa.