Herpes Simplex Virus Type 2 as a Potential Driver of Prostate Cancer Progression: Detection of Viral DNA in Prostate Tissue and Association with Tumor Aggressiveness

Herpes simplex virus type 2 (HSV2) has emerged as a potential contributing factor in prostate cancer (PCa) carcinogenesis, yet the relationship between local HSV2 infection in prostate tissue and cancer aggressiveness remains poorly understood. This study investigated the association between PCR detection of HSV2 DNA in prostate biopsy specimens and prostate cancer characteristics in a Moroccan cohort. A cross sectional study was conducted at Mohammed V Military Teaching Hospital, Rabat, Morocco, including 50 patients with histologically confirmed prostate adenocarcinoma and 50 control subjects. Presence of HSV2 DNA in prostate biopsy tissue was determined using conventional PCR, Data analysis was performed using Jamovi software to assess associations between HSV2 DNA presence in prostate tissue and clinicopathological variables such as age, PSA levels, Gleason score, and tumor stage. HSV2 DNA was detected in 26% (13/50) of prostate cancer patient biopsy specimens. A highly significant association was observed between tissue HSV2 DNA positivity and advanced tumor stage (χ² = 17.8, p < 0.001), with 100% of T3x-T4 patients being HSV2 DNA positive compared to 25% of T2x patients and 5.9% of T1 patients. The association demonstrated a strong effect size (Cramer's V = 0.597). Patients with HSV2 DNA positive biopsies showed a trend toward higher Gleason scores, with 92.3% presenting Gleason > 6 compared to 64.9% of HSV2 DNA negative patients (p = 0.058, moderate effect size). No significant associations were found between tissue HSV2 DNA positivity and PSA levels or patient age. This study provides preliminary evidence that the presence of HSV2 DNA in prostate tissue is strongly associated with advanced prostate cancer stage and shows trends toward higher tumor grade. The independence of these associations from traditional risk factors suggests that local HSV2 infection may contribute to aggressive prostate cancer, although causality cannot be established. These findings support the hypothesis that chronic viral infection may influence prostate cancer progression, warranting further investigation.