Al Bitar Samar, Ballouz Tala, Doughan Samer, Gali-Muhtasib Hala, Rizk Nesrine
Department of Biology, American University of Beirut, Beirut 1107 2020, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon.
World J Gastrointest Pathophysiol. 2021 Jul 22;12(4):59-83. doi: 10.4291/wjgp.v12.i4.59.
Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) continues to be a major global public health issue owing to the increased mortality rates related to the prevalent oncogenic viruses among people living with HIV (PLWH). Human papillomavirus (HPV) is the most common sexually transmitted viral disease in both men and women worldwide. High-risk or oncogenic HPV types are associated with the development of HPV-related malignancies, including cervical, penile, and anal cancer, in addition to oral cancers. The incidence of anal squamous cell cancers is increasing among PLWH, necessitating the need for reliable screening methods in this population at risk. In fact, the currently used screening methods, including the Pap smear, are invasive and are neither sensitive nor specific. Investigators are interested in circulatory and tissue micro ribonucleic acids (miRNAs), as these small non-coding RNAs are ideal biomarkers for early detection and prognosis of cancer. Multiple miRNAs are deregulated during HIV and HPV infection and their deregulation contributes to the pathogenesis of disease. Here, we will review the molecular basis of HIV and HPV co-infections and focus on the pathogenesis and epidemiology of anal cancer in PLWH. The limitations of screening for anal cancer and the need for a reliable screening program that involves specific miRNAs with diagnostic and therapeutic values is also discussed.
尽管抗逆转录病毒治疗(ART)取得了进展,但由于与人类免疫缺陷病毒(HIV)感染者(PLWH)中普遍存在的致癌病毒相关的死亡率上升,HIV仍然是一个主要的全球公共卫生问题。人乳头瘤病毒(HPV)是全球男性和女性中最常见的性传播病毒性疾病。高危或致癌性HPV类型与HPV相关恶性肿瘤的发生有关,包括宫颈癌、阴茎癌和肛门癌,以及口腔癌。PLWH中肛门鳞状细胞癌的发病率正在上升,因此需要在这一高危人群中采用可靠的筛查方法。事实上,目前使用的筛查方法,包括巴氏涂片检查,具有侵入性,既不敏感也不特异。研究人员对循环和组织微小核糖核酸(miRNA)感兴趣,因为这些小的非编码RNA是癌症早期检测和预后的理想生物标志物。在HIV和HPV感染期间,多种miRNA失调,它们的失调促成了疾病的发病机制。在这里,我们将回顾HIV和HPV合并感染的分子基础,并重点关注PLWH中肛门癌的发病机制和流行病学。还讨论了肛门癌筛查的局限性以及需要一个涉及具有诊断和治疗价值的特定miRNA的可靠筛查计划。