The Effect of HIV and HPV Co-infection on Cervical COX-2 Expression and Systemic Prostaglandin E2 Levels

摘要

Human immunodeficiency virus (HIV-1) infection causes chronic inflammation. COX-2 derived prostaglandin E2 (PGE2) has been linked to both inflammation and carcinogenesis. We hypothesized that HIV-1 could induce COX-2 in cervical tissue and increase systemic PGE2 levels and that these alterations could play a role in AIDS-related cervical cancer. Levels of cervical COX-2 mRNA and urinary PGE-M, a biomarker of systemic PGE2 levels, were determined in 17 HIV-negative women with a negative cervical HPV test, 18 HIV-infected women with a negative HPV test, and 13 HIV-infected women with cervical HPV and high-grade squamous intraepithelial lesions on cytology. Cervical COX-2 levels were significantly associated with HIV and HPV status (P=0.006 and 0.002, respectively). Median levels of urinary PGE-M were increased in HIV-infected compared to uninfected women (11.2 ng/mg creatinine vs. 6.8 ng/mg creatinine, P=0.02). Among HIV infected women, urinary PGE-M levels were positively correlated with plasma HIV-1 RNA levels (P<0.001). Finally, levels of cervical COX-2 correlated with urinary PGE-M levels (P=0.005). This study demonstrates that HIV-1 infection is associated with increased cervical COX-2 and elevated systemic PGE2 levels. Drugs that inhibit the synthesis of PGE2 may prove useful in reducing the risk of cervical cancer or systemic inflammation in HIV infected women.