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World J Gastrointest Pathophysiol. Jul 22, 2021; 12(4): 59-83
Published online Jul 22, 2021. doi: 10.4291/wjgp.v12.i4.59
Potential role of micro ribonucleic acids in screening for anal cancer in human papilloma virus and human immunodeficiency virus related malignancies
Samar Al Bitar, Tala Ballouz, Samer Doughan, Hala Gali-Muhtasib, Nesrine Rizk
Samar Al Bitar, Department of Biology, American University of Beirut, Beirut 1107 2020, Lebanon
Tala Ballouz, Nesrine Rizk, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
Samer Doughan, Department of Surgery, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
Hala Gali-Muhtasib, Department of Biology and Center for Drug Discovery, American University of Beirut, Beirut 1107 2020, Lebanon
Author contributions: Al Bitar S designed and wrote the first draft of the paper; Ballouz T contributed to writing the paper; Al Bitar S and Ballouz T collected and analyzed data; Doughan S, Gali-Muhtasib H, and Rizk N contributed to conception and reviewed and edited the paper; Al Bitar S, Ballouz T, Doughan S, Gali-Muhtasib H, Rizk N provided the final approval of the version to be published.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nesrine Rizk, MD, Assistant Professor, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, Beirut 1107 2020, Lebanon. nr00@aub.edu.lb
Received: March 17, 2021
Peer-review started: March 17, 2021
First decision: April 15, 2021
Revised: April 24, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 22, 2021
Processing time: 120 Days and 15.9 Hours
Abstract

Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) continues to be a major global public health issue owing to the increased mortality rates related to the prevalent oncogenic viruses among people living with HIV (PLWH). Human papillomavirus (HPV) is the most common sexually transmitted viral disease in both men and women worldwide. High-risk or oncogenic HPV types are associated with the development of HPV-related malignancies, including cervical, penile, and anal cancer, in addition to oral cancers. The incidence of anal squamous cell cancers is increasing among PLWH, necessitating the need for reliable screening methods in this population at risk. In fact, the currently used screening methods, including the Pap smear, are invasive and are neither sensitive nor specific. Investigators are interested in circulatory and tissue micro ribonucleic acids (miRNAs), as these small non-coding RNAs are ideal biomarkers for early detection and prognosis of cancer. Multiple miRNAs are deregulated during HIV and HPV infection and their deregulation contributes to the pathogenesis of disease. Here, we will review the molecular basis of HIV and HPV co-infections and focus on the pathogenesis and epidemiology of anal cancer in PLWH. The limitations of screening for anal cancer and the need for a reliable screening program that involves specific miRNAs with diagnostic and therapeutic values is also discussed.

Keywords: Human papillomavirus; Human immunodeficiency virus; Anal cancer; Micro ribonucleic acids; Biomarkers; Cancer screening

Core Tip: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. People living with human immunodeficiency virus (HIV) are at high risk of acquiring HPV infection and developing HPV-associated malignancies, including anal cancer, independent of acquired immune deficiency syndrome. This high risk is associated with several factors including the dysregulation of cellular micro ribonucleic acids (miRNAs) and the direct interaction between HIV and HPV. Dysregulated miRNAs are known to play a role in HIV, HPV infections, and HPV-related cancers. Here, we discuss the role of HIV in HPV-associated pathogenesis and important implications of miRNAs on current screening for and early detection of anal cancer.