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

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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.

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References and Recommended Reading

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  9. Frisch M, Biggar RJ, Engels EA, Goedert JJ: Association of cancer with AIDS-related immunosuppression in adults. JAMA 2001, 285:1736–1745.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

  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.

  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.

    Article  PubMed  Google Scholar 

  26. Hartevelt MM, Bavinck JN, Kootte AM, et al.: Incidence of skin cancer after renal transplantation in The Netherlands. Transplantation 1990, 49:506–509.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  29. Crothers K, Butt AA, Gibert CL, et al.: Increased COPD among HIV-positive compared to HIV-negative veterans. Chest 2006, 130:1326–1333.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  32. Antoniou T, Tseng AL: Interactions between antiretrovirals and antineoplastic drug therapy. Clin Pharmacokinet 2005, 44:111–145.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  37. Biggar RJ, Jaffe ES, Goedert JJ, et al.: Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS. Blood 2006, 108:3786–3791.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  46. Clifford GM, Goncalves MA, Franceschi S: Human papillomavirus types among women infected with HIV: a meta-analysis. AIDS 2006, 20:2337–2344.

    Article  PubMed  Google Scholar 

  47. Douek DC: Disrupting T-cell homeostasis: how HIV-1 infection causes disease. AIDS Rev 2003, 5:172–177.

    PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

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  1. VA North Texas Health Care System and University of Texas Southwestern Medical Center, 4500 South Lancaster Road, Dallas, TX, 75216, USA

    Roger Bedimo

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Bedimo, R. Non-AIDS-defining malignancies among HIV-infected patients in the highly active antiretroviral therapy era. Curr HIV/AIDS Rep 5, 140–149 (2008). https://doi.org/10.1007/s11904-008-0022-4

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