Aspirin may rid cervical cancer in HIV patients

Aspirin should be evaluated for its ability to prevent development of cervical cancer in HIV-infected women, a new study has suggested.

According to the new study, conducted by NewYork-Presbyterian Hospital/Weill Cornell Medical Center global health investigators and cancer specialists in New York, Qatar and Haiti, this simple and inexpensive solution has the potential to provide enormous benefit for women in the Caribbean, Latin America and Africa, who suffer from a disproportionately high rate of cervical cancer death.

Preventive aspirin use could be especially useful in Haiti, where invasive cervical cancer is a common cause of death in HIV-infected women. The country also has the highest reported incidence of cervical cancer in the world and one of the highest HIV infection rates in the Western Hemisphere.

“These young patients -- many of whom were mothers and the sole support for their families -- had worked hard to have their HIV controlled with antiretroviral therapy, only to develop and die from cervical cancer,” Daniel Fitzgerald, the study leader, said.

“The results of this collaborative effort will make a real difference for women living in one of the poorest nations in the world. “It is wonderful that clinicians and scientists from different parts of the world were able to come together to address such a critical issue of care,” he said. For the study, the researchers examined levels of COX-2 and PGE-M (a stable metabolite of PGE2) in three groups of women and found increased levels of both molecules in 13 women who were co-infected with HIV and HPV. COX-2 and PGE-M were also elevated in 18 HIV-infected women with a negative HPV test and lowest in 17 HIV-negative women who also were not infected with HPV.

The researchers discovered that HIV induces expression of the COX-2/prostaglandin E2 (PGE2) inflammatory pathway in cervical tissue samples from Haitian women who were infected with HIV. The findings tie two known facts together – that HIV causes chronic inflammation, and that PGE2, which is elevated during inflammation, is linked to cancer development in a number of tumour types, including cervical cancer.

The researchers also said that the fact that HIV ramps up production of PGE2 in cervical tissue was not known before this study.

This may help explain why HIV-positive women are five times more likely to develop invasive cervical cancer than HIV-negative women.