Associations of viral infections, including cutaneous warts, and sleep quality with immune function in treatment-naïve breast cancer patient: a cross-sectional study.

Background: Viral infections and sleep disturbance may be associated with immune dysregulation, but their relationship with baseline immune status in treatment-naïve breast cancer remains unclear. We investigated associations of viral infection history, including cutaneous warts, and sleep quality with peripheral lymphocyte counts. Methods: This cross-sectional study included 100 women with pathologically confirmed breast cancer who had received no antitumor therapy. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Data on psychological status, systemic viral infections, cutaneous warts, and absolute lymphocyte counts were collected. Group comparisons and multivariable linear regression were performed. Results: Systemic viral infections were reported in 41% of patients, including herpes zoster (8%), cervical HPV infection (5%), Epstein-Barr virus infection (2%), respiratory syncytial virus infection (2%), hepatitis B virus carrier status (3%), and other/unspecified viral infections (21%). Cutaneous warts were present in 40, and 62% had at least one type of viral infection. Sleep disorders were present in 73%, while 23% had lymphocyte counts below 1.1 × 10 Conclusion: Viral infections, cutaneous warts, and sleep disturbance were common and associated with lower baseline lymphocyte counts in treatment-naïve breast cancer. However, because cutaneous warts and systemic viral infections were not entered as separate predictors, the independent contribution of cutaneous warts was not established. These findings should be considered exploratory and hypothesis-generating.