Aspirin Could Help Prevent Cervical Cancer in Women with HIV

Women at a health clinic in Haiti (State.gov)

Research by global health investigators and cancer specialists suggests that aspirin should be evaluated for its ability to prevent development of cervical cancer in HIV-infected women. The findings by a team from New York-Presbyterian Hospital and Weill Cornell Medical Center in New York, with colleagues from Qatar and Haiti, are published in the current issue of the journal Cancer Prevention Research.

The study, led by Daniel Fitzgerald, professor of medicine at Weill Cornell Medical College, says simple and inexpensive aspirin has the potential to benefit for women in the Caribbean, Latin America and Africa, who suffer from a disproportionately high rate of cervical cancer death. Aspirin use could be especially useful in Haiti, which has the highest reported incidence of cervical cancer in the world and one of the highest HIV infection rates in the Western Hemisphere.

The researchers discovered that HIV induces expression of an inflammatory pathway in cervical tissue samples from Haitian women who were infected with HIV, called the the COX-2/prostaglandin E2 (PGE2). The findings connect the two known ideas that HIV causes chronic inflammation, and elevated PGE2 during inflammation is linked to cancer development in a number of tumor types, including cervical cancer. However, the researchers say the role played by HIV to increase production of PGE2 in cervical tissue was not known before this 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 team’s findings may help explain why HIV-positive women are five times more likely to develop invasive cervical cancer than HIV-negative women. The results also suggest that inhibitors of the COX-2 molecule that contributes to the production of PGE2 might break the link between HIV and cervical cancer. Aspirin is considered one of the least expensive and most effective COX inhibitors.

Fitzgerald is a member of the College’s Center for Global Health and directs its collaboration with GHESKIO, a Haitian NGO that provides clinical service, research, and training in HIV/AIDS. He lived in Haiti for seven years and continues to treat HIV patients there.

Read more: Univ. Researchers Develop Dry Powder HPV Vaccine

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