Current HIV/AIDS Reports

, Volume 5, Issue 3, pp 140–149

Non-AIDS-defining malignancies among HIV-infected patients in the highly active antiretroviral therapy era

Article

Abstract

In the highly active antiretroviral therapy (HAART) era, the incidence of AIDS-defining malignancies (ADMs) has declined significantly. On the other hand, the incidence of other malignancies not known to be associated with immunosuppression (non-ADMs) has not changed and remains significantly higher than in the general population. Some recent controlled studies even suggest that the incidence of selected non-ADMs has increased in the HAART era. These trends warrant a high index of suspicion for malignancies among HIV care providers and a renewed focus on understanding the mechanisms underlying the increased rates. Potential explanations for the higher non-ADM rates include longer survival of patients with HIV on HAART, with only partial immune recovery achieved in most patients; high incidence of human papillomavirus, Epstein-Barr virus, and hepatitis C virus coinfection in patients with HIV infection; and potential oncogenicity of long-term HIV infection or of long-term HAART.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Mocroft A, Brettle R, Kirk O, et al.: Changes in the cause of death among HIV positive subjects across Europe: results from the EuroSIDA study. AIDS 2002, 16:1663–1671.PubMedCrossRefGoogle Scholar
  2. 2.
    Palella FJ Jr, Delaney KM, Moorman AC, et al.: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998, 338:853–860.PubMedCrossRefGoogle Scholar
  3. 3.
    Sackoff JE, Hanna DB, Pfeiffer MR, Torian LV: Causes of death among persons with AIDS in the era of highly active antiretroviral therapy: New York City. Ann Intern Med 2006, 145:397–406.PubMedGoogle Scholar
  4. 4.
    Palella FJ Jr, Baker RK, Moorman AC, et al.: Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr 2006, 43:27–34.PubMedCrossRefGoogle Scholar
  5. 5.
    International Collaboration on HIV and Cancer: Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst 2000, 92:1823–1830.CrossRefGoogle Scholar
  6. 6.
    Clifford GM, Polesel J, Rickenbach M, et al.: Cancer risk in the Swiss HIV Cohort Study: associations with immunodeficiency, smoking, and highly active antiretroviral therapy. J Natl Cancer Inst 2005, 97:425–432.PubMedGoogle Scholar
  7. 7.
    Mbulaiteye SM, Biggar RJ, Goedert JJ, Engels EA: Immune deficiency and risk for malignancy among persons with AIDS. J Acquir Immune Defic Syndr 2003, 32:527–533.PubMedCrossRefGoogle Scholar
  8. 8.
    Herida M, Mary-Krause M, Kaphan R, et al.: Incidence of non-AIDS-defining cancers before and during the highly active antiretroviral therapy era in a cohort of human immunodeficiency virus-infected patients. J Clin Oncol 2003, 21:3447–3453.PubMedCrossRefGoogle Scholar
  9. 9.
    Frisch M, Biggar RJ, Engels EA, Goedert JJ: Association of cancer with AIDS-related immunosuppression in adults. JAMA 2001, 285:1736–1745.PubMedCrossRefGoogle Scholar
  10. 10.
    Engels EA, Brock MV, Chen J, et al.: Elevated incidence of lung cancer among HIV-infected individuals. J Clin Oncol 2006, 24:1383–1388.PubMedCrossRefGoogle Scholar
  11. 11.
    Dal Maso L, Tirelli U, Polesel J, Franceschi S: Trends in cancer incidence rates among HIV-infected patients. Clin Infect Dis 2005, 41:124–127.CrossRefGoogle Scholar
  12. 12.
    Vilchez RA, Finch CJ, Jorgensen JL, Butel JS: The clinical epidemiology of Hodgkin lymphoma in HIV-infected patients in the highly active antiretroviral therapy (HAART) era. Medicine (Baltimore) 2003, 82:77–81.CrossRefGoogle Scholar
  13. 13.
    Grulich AE, Li Y, McDonald A, et al.: Rates of non-AIDS-defining cancers in people with HIV infection before and after AIDS diagnosis. AIDS 2002, 16:1155–1161.PubMedCrossRefGoogle Scholar
  14. 14.
    Bedimo R, Chen RY, Accortt NA, et al.: Trends in AIDS-defining and non-AIDS-defining malignancies among HIV-infected patients: 1989–2002. Clin Infect Dis 2004, 39:1380–1384.PubMedCrossRefGoogle Scholar
  15. 15.
    Bower M, Powles T, Nelson M, et al.: HIV-related lung cancer in the era of highly active antiretroviral therapy. AIDS 2003, 17:371–375.PubMedCrossRefGoogle Scholar
  16. 16.
    Engels EA, Pfeiffer RM, Goedert JJ, et al.: Trends in cancer risk among people with AIDS in the United States 1980–2002. AIDS 2006, 20:1645–1654.PubMedCrossRefGoogle Scholar
  17. 17.
    Kirk GD, Merlo C, O’Driscoll P, et al.: HIV infection is associated with an increased risk for lung cancer, independent of smoking. Clin Infect Dis 2007, 45:103–110.PubMedCrossRefGoogle Scholar
  18. 18.
    Burgi A, Brodine S, Wegner S, et al.: Incidence and risk factors for the occurrence of non-AIDS-defining cancers among human immunodeficiency virus-infected individuals. Cancer 2005, 104:1505–1511.PubMedCrossRefGoogle Scholar
  19. 19.
    Hessol NA, Pipkin S, Schwarcz S, et al.: The impact of highly active antiretroviral therapy on non-AIDS-defining cancers among adults with AIDS. Am J Epidemiol 2007, 165:1143–1153.PubMedCrossRefGoogle Scholar
  20. 20.
    Baillargeon J, Pollock BH, Leach CT, Gao SJ: The association of neoplasms and HIV infection in the correctional setting. Int J STD AIDS 2004, 15:348–351.PubMedCrossRefGoogle Scholar
  21. 21.
    Phelps RM, Smith DK, Heilig CM, et al.: Cancer incidence in women with or at risk for HIV. Int J Cancer 2001, 94:753–757.PubMedCrossRefGoogle Scholar
  22. 22.
    Serraino D, Boschini A, Carrieri P, et al.: Cancer risk among men with, or at risk of, HIV infection in southern Europe. AIDS 2000, 14:553–559.PubMedCrossRefGoogle Scholar
  23. 23.
    Bedimo R, Dunlap M, McGinnis KA, Justice AC: Incidence of non-AIDS-defining malignancies in HIV-infected vs non-infected veterans in the HAART era: impact of immunosuppression. Presented at the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, IL; September 17–20, 2007.Google Scholar
  24. 24.
    Patel P, Novak RM, Tong T: Incidence of non-AIDS-defining malignancies in the HIV Outpatient Study. Presented at the 11th Conference on Retroviruses and Opportunistic Infections. San Francisco, CA; February 8–11, 2004.Google Scholar
  25. 25.
    Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM: Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 2007, 370:59–67.PubMedCrossRefGoogle Scholar
  26. 26.
    Hartevelt MM, Bavinck JN, Kootte AM, et al.: Incidence of skin cancer after renal transplantation in The Netherlands. Transplantation 1990, 49:506–509.PubMedCrossRefGoogle Scholar
  27. 27.
    Webb MC, Compton F, Andrews PA, Koffman CG: Skin tumours posttransplantation: a retrospective analysis of 28 years’ experience at a single centre. Transplant Proc 1997, 29:828–830.PubMedCrossRefGoogle Scholar
  28. 28.
    Furber AS, Maheswaran R, Newell JN, Carroll C: Is smoking tobacco an independent risk factor for HIV infection and progression to AIDS? Sex Transm Infect 2007, 83:41–46.PubMedCrossRefGoogle Scholar
  29. 29.
    Crothers K, Butt AA, Gibert CL, et al.: Increased COPD among HIV-positive compared to HIV-negative veterans. Chest 2006, 130:1326–1333.PubMedCrossRefGoogle Scholar
  30. 30.
    Bower M, Powles T, Newsom-Davis T, et al.: HIV-associated anal cancer: has highly active antiretroviral therapy reduced the incidence or improved the outcome? J Acquir Immune Defic Syndr 2004, 37:1563–1565.PubMedCrossRefGoogle Scholar
  31. 31.
    Fox P, Stebbing J, Portsmouth S, et al.: Lack of response of anal intra-epithelial neoplasia to highly active antiretroviral therapy. AIDS 2003, 17:279–280.PubMedCrossRefGoogle Scholar
  32. 32.
    Antoniou T, Tseng AL: Interactions between antiretrovirals and antineoplastic drug therapy. Clin Pharmacokinet 2005, 44:111–145.PubMedCrossRefGoogle Scholar
  33. 33.
    Sridhar KS, Flores MR, Raub WA Jr, Saldana M: Lung cancer in patients with human immunodeficiency virus infection compared with historic control subjects. Chest 1992, 102:1704–1708.PubMedCrossRefGoogle Scholar
  34. 34.
    Tirelli U, Spina M, Sandri S, et al.: Lung carcinoma in 36 patients with human immunodeficiency virus infection. The Italian Cooperative Group on AIDS and Tumors. Cancer 2000, 88:563–569.PubMedCrossRefGoogle Scholar
  35. 35.
    Powles T, Thirwell C, Newsom-Davis T, et al.: Does HIV adversely influence the outcome in advanced non-small-cell lung cancer in the era of HAART? Br J Cancer 2003, 89:457–459.PubMedCrossRefGoogle Scholar
  36. 36.
    Glaser SL, Clarke CA, Gulley ML, et al.: Population-based patterns of human immunodeficiency virus-related Hodgkin lymphoma in the Greater San Francisco Bay Area, 1988–1998. Cancer 2003, 98:300–309.PubMedCrossRefGoogle Scholar
  37. 37.
    Biggar RJ, Jaffe ES, Goedert JJ, et al.: Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS. Blood 2006, 108:3786–3791.PubMedCrossRefGoogle Scholar
  38. 38.
    Gerard L, Galicier L, Boulanger E, et al.: Improved survival in HIV-related Hodgkin’s lymphoma since the introduction of highly active antiretroviral therapy. AIDS 2003, 17: 81–87.PubMedCrossRefGoogle Scholar
  39. 39.
    Ribera JM, Navarro JT, Oriol A, et al.: Prognostic impact of highly active antiretroviral therapy in HIV-related Hodgkin’s disease. AIDS 2002, 16: 1973–1976.PubMedCrossRefGoogle Scholar
  40. 40.
    Biggar RJ, Engels EA, Ly S, et al.: Survival after cancer diagnosis in persons with AIDS. J Acquir Immune Defic Syndr 2005, 39:293–299.PubMedCrossRefGoogle Scholar
  41. 41.
    Carter MM, Torres SM, Cook DL Jr, et al.: Relative mutagenic potencies of several nucleoside analogs, alone or in drug pairs, at the HPRT and TK loci of human TK6 lymphoblastoid cells. Environ Mol Mutagen 2007, 48:239–247.PubMedCrossRefGoogle Scholar
  42. 42.
    Pluda JM, Venzon DJ, Tosato G, et al.: Parameters affecting the development of non-Hodgkin’s lymphoma in patients with severe human immunodeficiency virus infection receiving antiretroviral therapy. J Clin Oncol 1993, 11:1099–1107.PubMedGoogle Scholar
  43. 43.
    Kirk O, Pedersen C, Cozzi-Lepri A, et al.: Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood 2001, 98:3406–3412.PubMedCrossRefGoogle Scholar
  44. 44.
    Besson C, Goubar A, Gabarre J, et al.: Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood 2001, 98:2339–2344.PubMedCrossRefGoogle Scholar
  45. 45.
    Strickler HD, Burk RD, Fazzari M, et al.: Natural history and possible reactivation of human papillomavirus in human immunodeficiency virus-positive women. J Natl Cancer Inst 2005, 97:577–586.PubMedGoogle Scholar
  46. 46.
    Clifford GM, Goncalves MA, Franceschi S: Human papillomavirus types among women infected with HIV: a meta-analysis. AIDS 2006, 20:2337–2344.PubMedCrossRefGoogle Scholar
  47. 47.
    Douek DC: Disrupting T-cell homeostasis: how HIV-1 infection causes disease. AIDS Rev 2003, 5:172–177.PubMedGoogle Scholar
  48. 48.
    Sousa AE, Carneiro J, Meier-Schellersheim M, et al.: CD4 T cell depletion is linked directly to immune activation in the pathogenesis of HIV-1 and HIV-2 but only indirectly to the viral load. J Immunol 2002, 169:3400–3406.PubMedGoogle Scholar
  49. 49.
    Schacker TW, Nguyen PL, Martinez E, et al.: Persistent abnormalities in lymphoid tissues of human immunodeficiency virus-infected patients successfully treated with highly active antiretroviral therapy. J Infect Dis 2002, 186:1092–1097.PubMedCrossRefGoogle Scholar
  50. 50.
    Ahdieh L, Munoz A, Vlahov D, et al.: Cervical neoplasia and repeated positivity of human papillomavirus infection in human immunodeficiency virus-seropositive and-seronegative women. Am J Epidemiol 2000, 151:1148–1157.PubMedGoogle Scholar
  51. 51.
    Palefsky JM, Holly EA, Ralston ML, et al.: Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women. J Infect Dis 2001, 183:383–391.PubMedCrossRefGoogle Scholar
  52. 52.
    McGinnis KA, Fultz SL, Skanderson M, et al.: Hepatocellular carcinoma and non-Hodgkin’s lymphoma: the roles of HIV, hepatitis C infection, and alcohol abuse. J Clin Oncol 2006, 24:5005–5009.PubMedCrossRefGoogle Scholar
  53. 53.
    Cheng YW, Chiou HL, Sheu GT, et al.: The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women. Cancer Res 2001, 61:2799–2803.PubMedGoogle Scholar
  54. 54.
    Nyagol J, Leucci E, Onnis A, et al.: The effects of HIV-1 Tat protein on cell cycle during cervical carcinogenesis. Cancer Biol Ther 2006, 5:684–690.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.VA North Texas Health Care System and University of Texas Southwestern Medical CenterDallasUSA

Personalised recommendations