{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:58Z","timestamp":1789448578258,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Viral infections and sleep disturbance may be associated with immune dysregulation, but their relationship with baseline immune status in treatment-na\u00efve breast cancer remains unclear. We investigated associations of viral infection history, including cutaneous warts, and sleep quality with peripheral lymphocyte counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Systemic viral infections were reported in 41% of patients, including herpes zoster (8%), cervical HPV infection (5%), Epstein\u2013Barr 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\u202f\u00d7\u202f10\n                      <jats:sup>9<\/jats:sup>\n                      \/L. Patients with cutaneous warts had lower lymphocyte counts than those without warts (1.58\u202f\u00b1\u202f0.73 vs. 1.89\u202f\u00b1\u202f0.86\u202f\u00d7\u202f10\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Counts were also lower in patients with systemic viral infections than in those without (1.52\u202f\u00b1\u202f0.71 vs. 1.92\u202f\u00b1\u202f0.85\u202f\u00d7\u202f10\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01), and were lowest in patients with both systemic infections and cutaneous warts (1.38\u202f\u00b1\u202f0.64\u202f\u00d7\u202f10\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001 vs. no infection). Patients with sleep disorders also had lower counts than those with acceptable sleep (1.58\u202f\u00b1\u202f0.73 vs. 2.01\u202f\u00b1\u202f0.88\u202f\u00d7\u202f10\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Emotional distress was not independently associated with lymphocyte counts (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.36). In multivariable analysis, sleep disorder (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) and viral infection history (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) were independently associated with lower lymphocyte counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Viral infections, cutaneous warts, and sleep disturbance were common and associated with lower baseline lymphocyte counts in treatment-na\u00efve 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1886238","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:00Z","timestamp":1789446420000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of viral infections, including cutaneous warts, and sleep quality with immune function in treatment-na\u00efve breast cancer patient: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Hong","family":"Xu","sequence":"first","affiliation":[{"name":"Senior Department of General Surgery, The 1st Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Senior Department of General Surgery, The 1st Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bu","family":"Da","sequence":"additional","affiliation":[{"name":"Senior Department of General Surgery, The 1st Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqi","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.1097\/CM9.0000000000003278","article-title":"Incidence, mortality, and disability-adjusted life years of female breast cancer in China, 2022","volume":"137","author":"Sun","year":"2024","journal-title":"Chin Med J 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