Solving the relationship between HIV and cancer – InventUM

Dr. Sylvester takes steps to minimize cancer risk for high-risk HIV patients through education, screening, and early detection.

People infected with human immunodeficiency virus (HIV) can significantly control its devastating health effects and live longer with approved antiretroviral therapies. However, effective control of HIV does not ameliorate the high cancer risk of HIV patients.

“The immune system is well controlled by HIV drugs, so in theory these people should be less susceptible to malignancies than other people,” he said. Sylvester Comprehensive Cancer Center researcher Dr. Isabella Rosa-Cunha, Associate Professor of Infectious Diseases at the University of Miami Miller School of Medicine. “While this is probably true for most cancers, certain types of cancer affect people living with HIV more than the general population.”

According to Sylvester, factors contributing to increased cancer risk include non-adherence to or lack of access to HIV treatment and the aging of people living with HIV. Emmanuel Thomas, MDHe was appointed to the National Institutes of Health’s (NIH) Co-infectious Diseases and HIV-Related Cancer Research Branch in 2022.

Rosa Cunha said years of fighting HIV may have weakened her immune system, making her more susceptible to mutations at the cellular level and vulnerable to certain types of cancer. It is said that there is. She joined Sylvester’s colleagues. AIDS Malignant Tumor Consortiuma branch of the National Cancer Institute (NCI) dedicated to the study of malignancies in people living with HIV.

The relationship between HIV and cancer in South Florida

Concerns about increased cancer risk are particularly heightened in South Florida. For example, Miami-Dade County is the epicenter of the HIV/Acquired Immune Deficiency Syndrome (AIDS) epidemic in the United States, accounting for one-third of all new HIV diagnoses in Florida.

“There are complex reasons for this, including the large number of racially, ethnically and sexually diverse risk groups,” Dr. Thomas said. “Because of the diversity of South Florida’s population, HIV prevention presents a significant challenge.”

Three HIV-associated cancers, Kaposi’s sarcoma, B-cell non-Hodgkin’s lymphoma, and cervical cancer, are determinants of AIDS and signal progression to AIDS. According to the NCI, people with HIV are 500 times more likely to be diagnosed with Kaposi’s sarcoma, 12 times more likely to be diagnosed with non-Hodgkin’s lymphoma, and women are 3 times more likely to be diagnosed with cervical cancer. It is said to be expensive.

People with HIV are at increased risk of developing non-AIDS-defining cancers, including cancers of the anus, liver, mouth/pharynx, and lungs, as well as Hodgkin’s lymphoma.

Take a closer look at the issue

Viruses that can coexist with HIV cause many cancers that don’t define AIDS, Dr. Thomas said.

“HIV weakens the immune system and reduces the body’s ability to fight viral infections that can cause cancer,” he said. “These cancer-causing viruses include Epstein-Barr virus, human papillomavirus (HPV), hepatitis B and hepatitis C.”

According to Dr. Thomas, herpesvirus type 8 can cause Kaposi’s sarcoma, Epstein-Barr virus can cause non-Hodgkin’s lymphoma, and HPV can cause cervical, anal, and oropharyngeal cancer. However, hepatitis B and hepatitis C are said to be correlated with liver cancer.

Control the cancer threat

Mr. Sylvester addresses the issue of HIV and cancer with programs that focus on HIV prevention, uptake of antiretroviral therapy, and cancer screening for people living with HIV. The company’s game-changer vehicle provides HIV testing and screening for related cancers such as cervical cancer, blood cancers, and rare skin cancers such as Kaposi’s sarcoma.

“We have three mobile units that travel to communities in watersheds from Palm Beach County to Key West to provide a variety of cancer tests,” said BSW Director Valerie Bethel, Ph.D., MBA. /HCM says. Sylvester Outreach and Engagement Department. “We provide HIV and hepatitis testing to people who may be at high risk for contracting HIV and hepatitis. We also partner with other community partners and our sister program, the Miami AIDS Center, to provide We refer clients who need PrEP, a prophylactic method to prevent infection.”

Sylvester’s community support program provides counseling, referrals to community resources, and cancer prevention services, and Dr. Thomas is leading a program to test patients for HIV and hepatitis C in the University of Miami Health Tower Emergency Department. I helped raise it.

“Patients can be tested for both of these viruses free of charge while receiving the care they need in the emergency department,” Dr. Thomas said. “This program can help identify people with HIV who don’t know they’re infected so they can be notified and get treatment. It can also help identify people with HIV who aren’t receiving appropriate treatment. So we can help them get their HIV under control.”

Sylvester researchers are involved in research focused on preventing cancers such as anal cancer, which more frequently afflict people with HIV.

Dr. Rosa-Cunha led the Sylvester and Jackson Memorial Hospital facility in the national ANCHOR study, which found that treating precancerous anal lesions significantly reduces the risk of anal cancer in people with HIV. The results of a study of more than 10,000 people at high risk of cancer found that New England Medical Journal.

“Dr. Sylvester established South Florida’s only dedicated anal dysplasia program for the prevention of anal cancer,” said Dr. Rosa Cunha.

Dr. Thomas’ lab studies liver cancer biomarkers such as TREM-1.

“TREM-1 is associated with the development of liver cancer, so we are looking at the molecule and liver cancer for use as a biomarker to identify patients with hepatitis C and HIV, which are on the rise. We’re trying to understand its role in the development of “risk of developing liver cancer,” Dr. Thomas said.

Cancer prevention in people with HIV infection

According to Dr. Thomas, the first step in effective prevention is adherence to antiretroviral therapy.

“If antiretroviral therapy is properly managed, Kaposi’s sarcoma is definitely preventable,” he says.

The HPV vaccine is effective and recommended for eligible patients, as is routine screening for cervical and anal cancer. “Patients with co-infections need to be closely monitored for these cancers,” Dr. Thomas says. “In the case of hepatitis C, it is a curable virus. The best thing we can do for them is to cure hepatitis C, which greatly reduces the risk of liver cancer. ”

tag: Dr. Shria Kumar, HIV, Sylvester Comprehensive Cancer Center