HIV-Associated Anal Cancer

Khandwala, Pushti; Singhal, Sachi; Desai, Devashish; Parsi, Meghana; Potdar, Rashmika

doi:10.7759/cureus.14834

Cited by 6 publications

(6 citation statements)

References 32 publications

(37 reference statements)

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“…Cervical cancer in HIV-infected women shows specific features: it occurs at a younger age than in the general population, reveals advanced stages at presentation, develops metastases in unusual locations, demonstrates a poor response to treatment, a higher recurrence rate, and a shorter time interval to death [ 17 ]. Anal cancer is also more common in immunocompromised individuals, specifically PLWH [ 18 , 19 ]. Even in HIV patients with CD4 cell counts over 500/μL, the risk of developing anal cancer was shown to be more than 20-fold higher than among the general population [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

HIV-1 Reverse Transcriptase Expression in HPV16-Infected Epidermoid Carcinoma Cells Alters E6 Expression and Cellular Metabolism, and Induces a Hybrid Epithelial/Mesenchymal Cell Phenotype

Zhitkevich,

Bayurova,

Avdoshina

et al. 2024

Viruses

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The high incidence of epithelial malignancies in HIV-1 infected individuals is associated with co-infection with oncogenic viruses, such as high-risk human papillomaviruses (HR HPVs), mostly HPV16. The molecular mechanisms underlying the HIV-1-associated increase in epithelial malignancies are not fully understood. A collaboration between HIV-1 and HR HPVs in the malignant transformation of epithelial cells has long been anticipated. Here, we delineated the effects of HIV-1 reverse transcriptase on the in vitro and in vivo properties of HPV16-infected cervical cancer cells. A human cervical carcinoma cell line infected with HPV16 (Ca Ski) was made to express HIV-1 reverse transcriptase (RT) by lentiviral transduction. The levels of the mRNA of the E6 isoforms and of the factors characteristic to the epithelial/mesenchymal transition were assessed by real-time RT-PCR. The parameters of glycolysis and mitochondrial respiration were determined using Seahorse technology. RT expressing Ca Ski subclones were assessed for the capacity to form tumors in nude mice. RT expression increased the expression of the E6*I isoform, modulated the expression of E-CADHERIN and VIMENTIN, indicating the presence of a hybrid epithelial/mesenchymal phenotype, enhanced glycolysis, and inhibited mitochondrial respiration. In addition, the expression of RT induced phenotypic alterations impacting cell motility, clonogenic activity, and the capacity of Ca Ski cells to form tumors in nude mice. These findings suggest that HIV-RT, a multifunctional protein, affects HPV16-induced oncogenesis, which is achieved through modulation of the expression of the E6 oncoprotein. These results highlight a complex interplay between HIV antigens and HPV oncoproteins potentiating the malignant transformation of epithelial cells.

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Section: Introductionmentioning

confidence: 99%

HIV-1 Reverse Transcriptase Expression in HPV16-Infected Epidermoid Carcinoma Cells Alters E6 Expression and Cellular Metabolism, and Induces a Hybrid Epithelial/Mesenchymal Cell Phenotype

Zhitkevich,

Bayurova,

Avdoshina

et al. 2024

Viruses

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“…However, studies have shown that most HIV-infected women have not received timely vaccination to prevent initial HPV infection. 39 Thus, ensuring completion of the HPV vaccine series in teens and eligible adults is paramount. In addition, both HBV and HCV can cause hepatocellular carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Cancer burden in women with HIV on Medicaid: A nationwide analysis

Zhou

Koroukian

Navale

et al. 2023

Womens Health (Lond Engl)

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Background: Cancer is the leading cause of death in people living with HIV. In the United States, nearly 1 in 4 people living with HIV are women, more than half of whom rely on Medicaid for healthcare coverage. Objective: The objective of this study is to evaluate the cancer burden of women living with HIV on Medicaid. Design: We conducted a cross-sectional study of women 18–64 years of age enrolled in Medicaid during 2012, using data from Medicaid Analytic eXtract files. Methods: Using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes, we identified women living with HIV (n = 72,508) and women without HIV (n = 17,353,963), flagging the presence of 15 types of cancer and differentiating between AIDS-defining cancers and non-AIDS-defining cancers. We obtained adjusted prevalence ratios and 95% confidence intervals for each cancer and for all cancers combined, using multivariable log-binomial models, and additionally stratifying by age and race/ethnicity. Results: The highest adjusted prevalence ratios were observed for Kaposi’s sarcoma (81.79 (95% confidence interval: 57.11–117.22)) and non-Hodgkin’s lymphoma (27.69 (21.67–35.39)). The adjusted prevalence ratios for anal and cervical cancer, both of which were human papillomavirus-associated cancers, were 19.31 (17.33–21.51) and 4.20 (3.90–4.52), respectively. Among women living with HIV, the adjusted prevalence ratio for all cancer types combined was about two-fold higher (1.99 (1.86–2.14)) in women 45–64 years of age than in women 18–44 years of age. For non-AIDS-defining cancers but not for AIDS-defining cancers, the adjusted prevalence ratios were higher in older than in younger women. There was no significant difference in the adjusted prevalence ratios for all cancer types combined in the race/ethnicity-stratified analyses of the women living with HIV cohort. However, in cancer type–specific sub-analyses, differences in adjusted prevalence ratios between Hispanic versus non-Hispanic women were observed. For example, the adjusted prevalence ratio for Hispanic women for non-Hodgkin’s lymphoma was 2.00 (1.30–3.07) and 0.73 (0.58–0.92), respectively, for breast cancer. Conclusion: Compared to their counterparts without HIV, women living with HIV on Medicaid have excess prevalence of cervical and anal cancers, both of which are human papillomavirus related, as well as Kaposi’s sarcoma and lymphoma. Older age is also associated with increased burden of non-AIDS-defining cancers in women living with HIV. Our findings emphasize the need for not only cancer screening among women living with HIV but also for efforts to increase human papillomavirus vaccination among all eligible individuals.

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“…Author details 1 Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, RM. 230, Atlanta, GA 30324, USA.…”

Section: Abbreviationsmentioning

confidence: 99%

“…HPV-related anal cancer occurs in excess rates among people living with HIV (PLWH) [ 1 ], and has been increasing in incidence [ 1 ]. Notably, the incidence of anal cancer among men who have sex with men (MSM) is 20- to 40- fold greater relative to non-MSMs [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

An overview of implementing an evidence based program to increase HPV vaccination in HIV community clinics

et al. 2022

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Background HPV-related anal cancer occurs in excess rates among people living with HIV (PLWH) and has been increasing in incidence. The HPV vaccine is an effective and safe approach to prevent and reduce the risk of HPV-related disease. Yet, HPV vaccine programs tailored and implemented in the HIV population are lagging for this high-risk group. Methods A pre-post intervention study design will be used to tailor, refine, and implement the 4 Pillars™ Practice Transformation Program to increase HPV vaccination among PLWH. Guided by the RE-AIM framework, the CHAMPS study will provide training and motivation to HIV providers and clinic staff to recommend and administer the HPV vaccination within three HIV clinics in Georgia. We plan to enroll 365 HIV participants to receive HPV education, resources, and reminders for HPV vaccination. Sociodemographic, HPV knowledge, and vaccine hesitancy will be assessed as mediators and moderators for HPV vaccination. The primary outcome will be measured as an increase in uptake rate in initiation of the HPV vaccine and vaccine completion (secondary outcome) compared to historical baseline vaccination rate (control). Discussion The proposed study is a novel approach to address a serious and preventable public health problem by using an efficacious, evidence-based intervention on a new target population. The findings are anticipated to have a significant impact in the field of improving cancer outcomes in a high-risk and aging HIV population. Trial registration NCT05065840; October 4, 2021.

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HIV-Associated Anal Cancer

Cited by 6 publications

References 32 publications

HIV-1 Reverse Transcriptase Expression in HPV16-Infected Epidermoid Carcinoma Cells Alters E6 Expression and Cellular Metabolism, and Induces a Hybrid Epithelial/Mesenchymal Cell Phenotype

HIV-1 Reverse Transcriptase Expression in HPV16-Infected Epidermoid Carcinoma Cells Alters E6 Expression and Cellular Metabolism, and Induces a Hybrid Epithelial/Mesenchymal Cell Phenotype

Cancer burden in women with HIV on Medicaid: A nationwide analysis

An overview of implementing an evidence based program to increase HPV vaccination in HIV community clinics

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