Neoplastic conditions in the context of HIV-1 infection.
HIV-1 infection predisposes to the development of specific types of cancer. Most cancers seen in the AIDS setting are related to oncogenic virus infections, such as Epstein-Barr virus (EBV), Kaposi's sarcoma (KS)-associated herpesvirus (KSHV) and human papillomavirus (HPV). It is generally assumed that HIV-1 infection play a passive role in cancer development by impairing the host immune surveillance and increasing the risk of oncogenic virus infection. Recent insights, however, indicate that HIV-1 infection more actively promotes cancer growth. Experimental evidence has shown that HIV-1-encoded proteins can directly induce tumor angiogenesis and enhance KSHV transmission to target cells. Clinical evidence suggests that the oncogenicity of HPV is altered by the presence of HIV-1 infection irrespective of host immune status. The introduction of highly active antiretroviral therapy (HAART) has dramatically decreased the incidence of KS whereas the impact of HAART is variable in EBV-related lymphoma and HPV-related cervical cancer, suggesting that additional factors are involved in the pathogenesis of these cancers. Understanding the direct and indirect roles of HIV-1 in the pathogenesis of neoplastic conditions could provide the rationale for prevention and development of new treatments for AIDS-associated malignancies.
Aoki
Yoshiyasu
Y
Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. aokiy@mail.nih.gov
Tosato
Giovanna
G
D017088:AIDS-Related Opportunistic Infections / Q000209:etiology; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D015994:Incidence; D016483:Lymphoma, AIDS-Related / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012514:Sarcoma, Kaposi / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000209:etiology