Her research interests include the molecular epidemiology of cancer including both genetic and environmental factors involved in carcinogenesis. She is particularly interested in viruses that are directly or indirectly involved in cancer development and progression. Viruses and the human cancers with which they are associated include human papillomavirus (HPV) and cervical and other anogenital cancers, hepatitis B and C and hepatocellular (liver) cancers, Epstein-Barr virus (EBV) and nasopharyngeal cancers and certain lymphomas, and human herpesvirus 8 (HHV-8) and Kaposi’s sarcoma.

These infectious agents influence the development of cancer through varied mechanisms including interaction of viral genes with host tumor-suppressor genes, integration of virus into host DNA, and the establishment of persistent or latent infections. Understanding the role of host factors is key to elucidating the mechanism of viral carcinogenesis. Host immune responses to infection include humoral and cellular mechanisms and function to eliminate pathogens. Conditions resulting in immune suppression, such as HIV-infection and organ transplantation, often increase susceptibility to cancer development. Other host factors, such as diet, alcohol intake, and cigarette smoking, may also influence response to infection and subsequent neoplastic development.

Dr. Hernandez is presently a Co-Investigator in an NCI-funded study of HPV persistence, Cohort Study of Diet and Duration of HPV Infection. Along with study Principal Investigator, Dr. Marc Goodman, she has been involved in this investigation involving nearly 2,000 women on the island of Oahu during the past 5 years. Dr. Hernandez runs the HPV testing laboratory that uses state-of-the art DNA-based methods to detect the virus. HPV is a common sexually transmitted pathogen affecting an estimated 25% of adult females worldwide. Most HPV infections appear to clear after a relatively short period of time with no clinical consequence. Some infected women, however, develop a persistent infection with oncogenic HPV types and it is these women who are at greatest risk for developing cervical cancer. This study seeks to understand the determinants of persistent HPV infection including host and viral factors.

Dr. Hernandez is the Principal Investigator in a new NIH-funded study, the Molecular Epidemiology and Natural History of HPV infection in Heterosexual Men. Her study is part of the new Pacific Center for Emerging Infectious Disease Research headed by Dr. Richard Yanagihara of the University of Hawaii. The high prevalence of cervical HPV infection in women suggests that it is efficiently transmitted from male sexual partners, but men have been comparatively neglected in population-based research on HPV. Dr. Hernandez’s new five-year study will establish a multiethnic cohort of adult men who will be followed over 2 years. This study will investigate the molecular epidemiology and natural history of HPV infection among heterosexual men including viral and host factors associated with genital HPV infection. New knowledge gained from this investigation may contribute to improved prevention and control of this very common sexually transmitted agent in both men and women and subsequent reduction of HPV-associated sequelae.

The Hawaii Tumor Registry is a part of the Surveillance Epidemiology and End Results (SEER) Program of the National Cancer Institute. The Registry provides complete cancer reporting for the entire state and monitors trends in cancer incidence and mortality over time. Dr. Hernandez has also been involved in the HTR’s efforts to develop a tissue bank consisting of cancer tissue specimens. Archived tissue specimens have been increasingly recognized as a valuable research resource that can be used to evaluate nucleic acid and protein based measures of cancer etiology, progression, and prognosis. Through techniques such as immunohistochemistry and in situ hybridization, archival tissue can be used to detect genetic polymorphisms and mutations, oncogene expression, as well as environmental and infectious exposures. Dr. Hernandez anticipates that the HTR’s tissue bank will provide a rich research resource for local and national investigators.