Association of Oncogenic Viral Infections With Cardiovascular Risk and Health Outcomes: A Cross-Sectional Study in South Asian Adults.

BACKGROUND

Cardiovascular disease (CVD) is a major global health issue. Chronic infections with oncogenic viruses such as human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), and human T-cell lymphotropic virus type 1 (HTLV-1) may increase cardiovascular risk. Evidence from high-burden regions, such as Pakistan and India, is limited. This study examines the association between oncogenic viral infections and cardiovascular health in South Asian adults.

METHODS

This cross-sectional study was conducted in a community-based clinic in Pakistan and India from May to August 2025. The sample comprised 203 adults with a documented history of oncogenic viral infection (HPV, HBV, HCV, EBV, or HTLV-1) but without any previously diagnosed CVD. Structured questionnaires were used to collect data on demographic settings, viral infection, cardiovascular symptoms, and lifestyle factors. Cardiovascular health was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ), and cardiovascular risk was evaluated using the INTERHEART Modifiable Risk Score (IHMRS). Statistical analysis was performed using the IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, New York, United States), which included descriptive statistics, correlation analysis, regression models, and the adjustment for confounding factors, including age, gender, and treatment history.

RESULTS

Most of the participants were women (110, 54%), aged 36-45 years (60, 30%). A substantial positive relationship was found between the diagnosis of viral infection and the KCCQ (r = 0.298, p < 0.01) and IHMRS (r = 0.267, p < 0.01). Active viral disease was associated with decreased cardiovascular health outcomes in participants, as indicated by reduced KCCQ scores (p = 0.016). A significant gender difference was observed, with females exhibiting poorer cardiovascular health (p = 0.040). An association was observed between better cardiovascular outcomes and vaccination, timely treatment, and viral resorption.

CONCLUSION

The results suggest a significant association between oncogenic virus infections and cardiovascular health. Therefore, timely diagnosis, vaccination, and effective management are recommended to reduce cardiovascular risk. The findings underscore the importance of targeted health interventions, particularly in areas with high rates of viral infections, in mitigating long-term cardiovascular consequences.