People living with HIV (PLWH) have significantly higher cancer incidence compared to people without HIV for cancers caused by HPV (cervical, vulvar, anal, penile, and oropharyngeal), and altered immunity, not simply immunodeficiency, is one proposed mechanism driving this excess risk. The tumor viral and immune milieu are likely major factors contributing to these cancer disparities among PLWH, but few studies have examined the factors (viral and immune) that underlie differences in the cancer burden by HIV status, which is critical information needed to develop improved cancer prevention and treatment strategies for PLWH. Project 1’s overall goal is to inform the development of effective prevention and treatment strategies for HPV-related cancers among PLWH in SSA through thorough investigation of the viral and tumor immune factors associated with HPV-cancers and treatment outcomes using viral and immune profiling tools and high-dimensional technologies.
Staci Sudenga, MD (Co-Project Leader; Vanderbilt University Medical Center) is an Assistant Professor of Medicine in the Division of Epidemiology within the Department of Medicine at Vanderbilt University Medical Center. Dr. Sudenga earned her PhD in epidemiology from the University of Alabama at Birmingham and pursued training at the Moffitt Cancer Center in Tampa as a postdoctoral fellow under the R25T Molecular and Genetic Epidemiology of Cancer training award. Her research program focuses on infections and cancer, the natural history of infections, and the synergy between infections.
Hennie Botha, MD, PhD (Co-Project Leader; Stellenbosch University) is an academic gynecological oncologist and Executive Head of the Department of Obstetrics and Gynecology. His research focuses on the prevention and treatment of cervical cancer, the interaction of HPV disease and HIV, and in fertility preservation of women with cancer. He has experience in international collaborative research including co-leading with Dr Giuliano the EVRI Trial, a vaccine trial conducted among young women at very high risk of HIV acquisition in South Africa.
Shari Pilon-Thomas, PhD (Co-Investigator, Moffitt Cancer Center) is a Senior Member of the Immunology Department at Moffitt Cancer Center. She received her PhD in Immunology/Microbiology from Wayne State University and completed her Postdoctoral Fellow in the Department of Surgery, Tumor Immunology, Immunotherapy from University of Michigan in Ann Arbor. Her research focuses on the advancement of immunotherapy, specifically vaccine-based approaches and adoptive T cell therapy for a wide variety of solid tumors.
Conjunctival squamous cell carcinoma (cSCC) is an eye cancer with unknown etiology that disproportionately impacts sub-Saharan Africa, a setting where presentation with advanced disease is common and prevalence of Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) infection is high. People living with HIV (PLWH), a population highly susceptible to virus-associated cancers, have a pronounced elevation of cSCC cancer incidence, suggesting a potential viral etiology for this tumor. Project 2 seeks to determine if EBV infection is causally linked to the development of cSCC in PLWH in sub-Saharan Africa, laying the groundwork for future development of EBV targeted therapeutics and early detection biomarkers of cSCC.
Anna Coghill, PhD (Co-Project Leader; Moffitt Cancer Center) is an Assistant Member in the Cancer Epidemiology Program at the H. Lee Moffitt Cancer Center & Research Institute. Her publications using the HIV/AIDS Cancer Match Study and National Cancer Database, as well as collaborations with the Brazilian National Cancer Institute, have established that HIV-infected cancer patients experience worse stage-specific survival that their HIV-uninfected counterparts. Her research program is now focused on identifying both healthcare-related and molecular reasons for this survival disparity, and she serves as the Moffitt Site Principal Investigator for the AIDS Malignancy Consortium, an NCI-funded clinical trials network to support innovative cancer prevention and treatment trials for PLWH and cancer.
Margaret Borok, MBChB, FRCP (Project Co-Leader; University of Zimbabwe) is a Professor of Internal Medicine at the University of Zimbabwe Faculty of Medicine and Health Sciences, with 20 years of experience in clinical research and research management. She manages the only referral clinic for patients with AIDS and Kaposi Sarcoma (KS), and she is a member of the international committee and KS working group of the AIDS Malignancy Consortium (AMC) under the National Cancer Institute.
Racheal S. Dube Mandishora, PhD (Co-Investigator; Moffitt Cancer Center & University of Zimbabwe) is a trained Molecular Virologist and Cancer Epidemiologist with a robust research profile focused on the biology of oncoviruses, including Human Papillomavirus (HPV) and Epstein-Barr Virus (EBV). Her work explores the interplay between these viruses and HIV in the development of human diseases and cancers. She has led and co-led studies on the molecular characterization and prevalence of HPV across various anatomical sites—cervico-vaginal, anal, vulval, and ocular—in the Zimbabwean population, with a particular focus on individuals living with HIV (PLWH). She also co-leads Project 2 of the PAVILION project, investigating the role of EBV in conjunctival lesions among Zimbabwean participants.