Genital cytokines in HIV/ human papillomavirus co-infection: a systematic review.

BACKGROUND: Cervical cancer is the fourth cancer in incidence and the third mortality among women worldwide. Women living with HIV have a significantly increased risk of cervical cancer. The immune response of the host is crucial to determine the course of the HPV infection and cytokines play an important role modulating viral multiplication and concentrating the immune response in the Th1 or Th2 pattern. The aim of the present study is to evaluate the available evidence on the concentration of genital cytokines and their role in HPV infection in HIV-infected women.

METHODS: A systematic search of the literature was performed using MEDLINE via PubMed, Embase, Cochrane, LILACS, Scopus, Science direct and Web of Science databases on November, 2020 in which the following clusters of terms were applied: HIV infection, HPV infection and cytokine. Initially, 728 articles were selected, but only seventeen were eligible for full-text review and among them nine were included in the qualitative analysis. No restrictions were applied in language, publication date or status.

RESULTS: The most studied cytokines in the articles included in this review were: INF-γ and IL-10 (6 articles), TNF and IL-6 (5 articles) and macrophage inflammatory protein-MIP (4 articles). The main findings show that there is a reduction in the number of cells expressing IFN- γ (p=0.02) and TNF- α (p=0.01), in the cervices of HIV-HPV coinfected women compared with those infected only by HPV. In addition, levels of IL-6 (p= 0.039) and IL-10 (p= 0.02) are increased in the cervical secretions of HIV positive women compared to seronegative patients.

CONCLUSION: Despite these finding there is a clear need of larger studies to understand the role of these immune factors in HPV-induced cervical neoplasia of women co-infected with HIV.