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Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts

Despite the use of antiretroviral therapy, cervical cancer remains a leading malignancy in women with HIV, who face a six-fold increased risk. Infection with HIV and HPV has been linked to accelerated cervical cancer development. However, there are limited studies on the role of host somatic variati...

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Main Author: Mabizela, Nosipho
Other Authors: Dandara, Collet. Soko, Nyarai
Format: Thesis
Language:English
English
Published: Department of Pathology 2025
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access_status_str Open Access
author Mabizela, Nosipho
author2 Dandara, Collet. Soko, Nyarai
author_browse Dandara, Collet. Soko, Nyarai
Mabizela, Nosipho
author_facet Dandara, Collet. Soko, Nyarai
Mabizela, Nosipho
author_sort Mabizela, Nosipho
collection Thesis
description Despite the use of antiretroviral therapy, cervical cancer remains a leading malignancy in women with HIV, who face a six-fold increased risk. Infection with HIV and HPV has been linked to accelerated cervical cancer development. However, there are limited studies on the role of host somatic variations in HIV-positive and HIV-negative women on cervical cancer. Understanding these variations may help identify potential genetic factors that contribute to accelerated cervical cancer development and differential response to treatment. This knowledge is important in targeting interventions and improving outcomes for women with HIV and cervical cancer. Therefore, this study aims to investigate host somatic genetic variation between cervical biopsies obtained from HIV-positive or HIV-negative women with histologically confirmed CIN3 to determine potential differences in genomic landscapes and HPV infection between HIV-positive and HIV-negative women. The matched case-control study utilized archived cervical biopsies from 88 women (44 HIV positive, 44 HIV-negative) attending Groote Schuur Hospital Cancer Clinic between 2020 and 2022. The cases and controls were carefully age matched. HPV infection and type were confirmed using the Anyplex™ II HPV28 Detection kit. In cervical cancer, six hotspot regions in the four commonly mutated genes (TP53, PIK3CA, PTEN, and EGFR) were genotyped using Polymerase Chain Reaction and validated using Sanger Sequencing. Missense variant pathogenicity was assessed using SIFT, Polyphen-2, and ClinVar tools. The median age was [37 years (IQR:34-41)] for HIV-positive women and [35 years (IQR:32- 43)] for HIV-negative women. In the HIV-negative cohort the women reported tobacco smoking (p<0.0001), menstruation irregularities (p=0.005), and contraception usage (p=0.019). These parameters were statistically significant when compared to HIV-positive cohort. Common HPV types identified were HPV 16 (43/88, 49%), 35 (12/88, 14%), and 58 (10/88, 11%). A total of 232 genetic variants were identified, with HIV-positive women having a significantly higher burden of pathogenic variants (31%) compared to 15% among the HIV-negative (p=0.0406). Identified mutations included stop-gain, missense, synonymous, and intron variants. The genes TP53 and PIK3CA had more stop-gain variants among HIV-positive women (4/5) compared to HIV-negative women with 1/5 of the 5 mutations. These damaging variants were more prevalent in women under 50 in both cohorts. In conclusion, younger women (<50 years) showed predominantly damaging variants, indicating more aggressive cancer, and a possible reason for early onset in the younger cohort. HIV-positive women displayed a higher mutation burden in PIK3CA and pathogenic variants in TP53, emphasizing the need to further explore these genes in gene expression studies.
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language English
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
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spelling oai:open.uct.ac.za:11427/41029 Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts Mabizela, Nosipho Dandara, Collet. Soko, Nyarai Naidoo, Richard HIV-positive HIV-negative TP53 PIK3CA EGFR Despite the use of antiretroviral therapy, cervical cancer remains a leading malignancy in women with HIV, who face a six-fold increased risk. Infection with HIV and HPV has been linked to accelerated cervical cancer development. However, there are limited studies on the role of host somatic variations in HIV-positive and HIV-negative women on cervical cancer. Understanding these variations may help identify potential genetic factors that contribute to accelerated cervical cancer development and differential response to treatment. This knowledge is important in targeting interventions and improving outcomes for women with HIV and cervical cancer. Therefore, this study aims to investigate host somatic genetic variation between cervical biopsies obtained from HIV-positive or HIV-negative women with histologically confirmed CIN3 to determine potential differences in genomic landscapes and HPV infection between HIV-positive and HIV-negative women. The matched case-control study utilized archived cervical biopsies from 88 women (44 HIV positive, 44 HIV-negative) attending Groote Schuur Hospital Cancer Clinic between 2020 and 2022. The cases and controls were carefully age matched. HPV infection and type were confirmed using the Anyplex™ II HPV28 Detection kit. In cervical cancer, six hotspot regions in the four commonly mutated genes (TP53, PIK3CA, PTEN, and EGFR) were genotyped using Polymerase Chain Reaction and validated using Sanger Sequencing. Missense variant pathogenicity was assessed using SIFT, Polyphen-2, and ClinVar tools. The median age was [37 years (IQR:34-41)] for HIV-positive women and [35 years (IQR:32- 43)] for HIV-negative women. In the HIV-negative cohort the women reported tobacco smoking (p<0.0001), menstruation irregularities (p=0.005), and contraception usage (p=0.019). These parameters were statistically significant when compared to HIV-positive cohort. Common HPV types identified were HPV 16 (43/88, 49%), 35 (12/88, 14%), and 58 (10/88, 11%). A total of 232 genetic variants were identified, with HIV-positive women having a significantly higher burden of pathogenic variants (31%) compared to 15% among the HIV-negative (p=0.0406). Identified mutations included stop-gain, missense, synonymous, and intron variants. The genes TP53 and PIK3CA had more stop-gain variants among HIV-positive women (4/5) compared to HIV-negative women with 1/5 of the 5 mutations. These damaging variants were more prevalent in women under 50 in both cohorts. In conclusion, younger women (<50 years) showed predominantly damaging variants, indicating more aggressive cancer, and a possible reason for early onset in the younger cohort. HIV-positive women displayed a higher mutation burden in PIK3CA and pathogenic variants in TP53, emphasizing the need to further explore these genes in gene expression studies. 2025-02-26T11:27:28Z 2025-02-26T11:27:28Z 2024 2025-02-26T11:23:07Z Thesis / Dissertation Masters MSc http://hdl.handle.net/11427/41029 en eng application/pdf Department of Pathology Faculty of Health Sciences University of Cape Town
spellingShingle HIV-positive
HIV-negative
TP53
PIK3CA
EGFR
Mabizela, Nosipho
Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
thesis_degree_str Master's
title Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
title_full Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
title_fullStr Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
title_full_unstemmed Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
title_short Host somatic variation between women living with HIV with cervical intraepitheial lesions (CIN3) and their HIV negative counterparts
title_sort host somatic variation between women living with hiv with cervical intraepitheial lesions cin3 and their hiv negative counterparts
topic HIV-positive
HIV-negative
TP53
PIK3CA
EGFR
url http://hdl.handle.net/11427/41029
work_keys_str_mv AT mabizelanosipho hostsomaticvariationbetweenwomenlivingwithhivwithcervicalintraepitheiallesionscin3andtheirhivnegativecounterparts