Abstract

Simple SummaryPeople living with human immunodeficiency virus type 1 (HIV-1) (PLWH) are at increased risk of developing cancer despite successful antiretroviral therapy (ART). Here, authors suggest novel mechanism behind this phenomenon. HIV proteins, namely envelope protein gp120, accessory protein negative factor Nef, matrix protein p17, transactivator of transcription Tat and reverse transcriptase RT, are known to be oncogenic per se, to induce oxidative stress and to be released from the infected or expressing cells. These properties are proposed to underlie their capacity to affect bystander epithelial cells causing their malignant transformation, and to enhance tumorigenic potential of already transformed/cancer cells. HIV proteins can act alone or in collaboration with other known oncoproteins, specifically originating from the oncogenic human viruses such as human hepatitis B and C viruses, and human papilloma viruses of high carcinogenic risk, which cause the bulk of malignancies in people living with HIV-1 on ART. People living with human immunodeficiency virus (HIV-1) are at increased risk of developing cancer, such as Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), cervical cancer, and other cancers associated with chronic viral infections. Traditionally, this is linked to HIV-1-induced immune suppression with depletion of CD4+ T-helper cells, exhaustion of lymphopoiesis and lymphocyte dysfunction. However, the long-term successful implementation of antiretroviral therapy (ART) with an early start did not preclude the oncological complications, implying that HIV-1 and its antigens are directly involved in carcinogenesis and may exert their effects on the background of restored immune system even when present at extremely low levels. Experimental data indicate that HIV-1 virions and single viral antigens can enter a wide variety of cells, including epithelial. This review is focused on the effects of five viral proteins: envelope protein gp120, accessory protein negative factor Nef, matrix protein p17, transactivator of transcription Tat and reverse transcriptase RT. Gp120, Nef, p17, Tat, and RT cause oxidative stress, can be released from HIV-1-infected cells and are oncogenic. All five are in a position to affect “innocent” bystander cells, specifically, to cause the propagation of (pre)existing malignant and malignant transformation of normal epithelial cells, giving grounds to the direct carcinogenic effects of HIV-1.

Highlights

  • Immune suppression and related dysfunctions result in a high prevalence in people living with human immunodeficiency virus (PLWH) of HIV-1/AIDS-associated disorders, including so called AIDS-defining cancers (ADC)—Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL) and cervical cancer

  • This abnormal immunoactivation emerges as the cumulative effect of thymic dysfunction, antiretroviral therapy (ART) toxicity, persistent antigen stimulation caused by co-infections, microbial translocation, residual viremia and dysbiosis [10], aggravated by incomplete recovery of CD4+ T cell functions and intrinsic B and T cell defects on the background of persistent aberrant activation of monocytes, natural killer cells (NK) and innate lymphoid cells [7,11,12].The immune deficiency and dysfunction of the immune system may not be the only cause [13]

  • The category of non-AIDS-defining cancers (NADC) includes liver cancer related to infections with hepatitis B and C viruses (HBV and HCV), brain cancer, and cancers associated with infection with human papillomaviruses of high oncogenic risk (HR HPVs), the anal cancer

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Summary

Introduction

Immune suppression and related dysfunctions result in a high prevalence in people living with human immunodeficiency virus (PLWH) of HIV-1/AIDS-associated disorders, including so called AIDS-defining cancers (ADC)—Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL) and cervical cancer. There is a significant increase in the number of yearly diagnosed cases of non-AIDS-defining cancers [1] The incidence of these malignancies among PLWH remains elevated compared to that in uninfected population despite successful ART. Hyper-immunoactivation and inflammation persisting in PLWH is recognized as a major cause of HIV-1 associated malignances This abnormal immunoactivation emerges as the cumulative effect of thymic dysfunction, ART toxicity, persistent antigen stimulation caused by co-infections, microbial translocation, residual viremia and dysbiosis [10], aggravated by incomplete recovery of CD4+ T cell functions and intrinsic B and T cell defects on the background of persistent aberrant activation of monocytes, natural killer cells (NK) and innate lymphoid cells [7,11,12].The immune deficiency and dysfunction of the immune system may not be the only cause [13]. The category of non-AIDS-defining cancers (NADC) includes liver cancer related to infections with hepatitis B and C viruses (HBV and HCV), brain cancer, and cancers associated with infection with human papillomaviruses of high oncogenic risk (HR HPVs), the anal cancer

Liver Cancer
Brain Cancer
Squamous Cell Carcinomas
Mechanisms Underlying HIV-1 Pathogenicity in Epithelial Cells
Envelope Glycoprotein gp120
Matrix Protein p17
Oncogenic HIV-1 Proteins Induce Oxidative Stress
Transactivator of Transcription
Envelope Protein Gp120
Accessory Protein Negative Factor
Reverse Transcriptase
Envelope Protein gp120
Findings
Conclusions
Full Text
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