Interaction of HIV, herpesviruses and tumor microenvironment in the pathogenesis of colorectal cancer

In this analytical review, the authors present the epidemiology of HIV infection and malignant neoplasms, as well as the relationship between these diseases. At the end of 2023, the total number of people living with HIV was 39.9 million, with 77% of them receiving antiretroviral therapy (ART). With the introduction of ART, the mortality structure among HIV-positive individuals has changed: the incidence of AIDS-defining neoplasms (ADM) has decreased, but the proportion of non-AIDS-defining tumors (nADM) has increased. The main predictors of mortality from nADM are low CD4+ lymphocytes, old age, smoking, and coinfection with viral hepatitis. The epidemiology of colorectal cancer (CRC), which ranks third in incidence among oncological diseases, is considered. CRC most often develops from precancerous lesions such as adenomas and serrated lesions of the colon, and its risk increases with age, obesity, smoking, and low physical activity. Particular attention is paid to the relationship between HIV infection and the development of CRC, as well as the role of viruses such as Epstein-Barr virus and cytomegalovirus in carcinogenesis. HIV infection contributes to the development of chronic inflammatory processes in the colorectal localization, which may increase the risk of developing CRC. Possible mechanisms linking HIV with the development of CRC, including the impact of ART and immunosuppression, are discussed. Potential therapeutic approaches associated with the use of anti-HIV drugs for the treatment of cancer are also considered.