Abstract

Cervical cancer is a public health problem and has devastating effects in low-to-middle-income countries (LTMICs) such as the sub-Saharan African (SSA) countries. Infection by the human papillomavirus (HPV) is the main cause of cervical cancer. HIV positive women have higher HPV prevalence and cervical cancer incidence than their HIV negative counterparts do. Concurrent HPV/HIV infection is catastrophic, particularly to African women due to the high prevalence of HIV infections. Although various studies show a relationship between HPV, HIV and cervical cancer, there is still a gap in the knowledge concerning the precise nature of this tripartite association. Firstly, most studies show the relationship between HPV and cervical cancer at genomic and epigenetic levels, while the transcriptomic landscape of this relationship remains to be elucidated. Even though many studies have shown HPV/HIV dual viral pathogenesis, the dual molecular oncoviral effects on the development of cervical cancer remains largely uncertain. Furthermore, the effect of highly active antiretroviral therapy (HAART) on the cellular splicing machinery is unclear. Emerging evidence indicates the vital role played by host splicing events in both HPV and HIV infection in the development and progression to cervical cancer. Therefore, decoding the transcriptome landscape of this tripartite relationship holds promising therapeutic potential. This review will focus on the link between cellular splicing machinery, HPV, HIV infection and the aberrant alternative splicing events that take place in HIV/HPV-associated cervical cancer. Finally, we will investigate how these aberrant splicing events can be targeted for the development of new therapeutic strategies against HPV/HIV-associated cervical cancer.

Highlights

  • Cervical cancer can be divided into two main types, squamous cell carcinoma (SCC) and adenocarcinoma (AC)

  • This review focuses on the link between cellular splicing machinery, human papillomavirus (HPV)/human immunodeficiency virus (HIV) infection and the aberrant alternative splicing events that take place in HIV/HPV-associated cervical cancer

  • The sub-Saharan African (SSA) region has the highest burden of dual HPV/HIV viral infections, exacerbating the cervical cancer pandemic in this region

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Summary

Introduction

Cervical cancer can be divided into two main types, squamous cell carcinoma (SCC) and adenocarcinoma (AC). In sub-Saharan Africa (SSA), HIV positive women have increased HPV prevalence and cervical cancer incidence compared to HIV negative women. This may be partly attributed to HIV’s altering effect on HPV pathogenesis. A comprehensive background knowledge of the molecular mechanisms involved in the dual HPV/HIV infection promoting cervical cancer pathogenesis can aid in the development of informed cervical cancer management, policy and decision-making. This is especially true for HIV positive women. We investigate how these aberrant splicing events can be targeted for the development of new therapeutic strategies against HPV/HIV-associated cervical cancer

Cervical Cancer Epidemiology
HPV Pathogenesis
HPV-Related Cancers
HPV and Splicing
HPV and Alternate mRNA Splicing
HIV and Alternate mRNA Splicing
Splicing Factors Deregulation in Cervical Cancer
Findings
Conclusions
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