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Impact of Antiretroviral Therapy on Cancer Treatment Outcomes among People Living with HIV in Low- and Middle-Income Countries: a Systematic Review

  • HIV Pathogenesis and Treatment (AL Landay and NS Utay, Section Editors)
  • Published:
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Abstract

Purpose of Review

The relationship between antiretroviral therapy (ART) and cancer treatment outcomes among people living with HIV (PLWH) in low- and middle-income countries (LMICs) is complex and poorly understood for many cancers. We aimed to summarize existing evidence from LMICs regarding the benefit of ART on cancer treatment–related outcomes.

Recent Findings

We included twelve observational studies that reported associations between ART status and cancer treatment outcomes among HIV-positive patients in LMICs. Most confirmed ART was associated with improved cancer treatment outcomes. Heterogeneity in cancers under study, outcome measurement, categorization of ART status, and reporting of HIV-related immune function made formal comparison between studies untenable.

Summary

Where evaluated, ART generally has a positive effect on cancer outcomes in people with HIV in LMICs. However, there remains a substantial gap in the literature regarding the impact of ART on treatment outcomes for most cancer types. Future research should focus on the optimal timing and integration of ART and cancer treatment for PLWH with strategies applicable to constrained-resource settings.

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Authors and Affiliations

  1. Department of Biochemistry, University of Washington, Box 357236, Seattle, WA, 98195, USA

    Michalina A Montaño

  2. Department of Global Health, University of Washington, Seattle, WA, USA

    Michalina A Montaño

  3. UNC Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi

    Maganizo B Chagomerana

  4. Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Maganizo B Chagomerana & Matthew Painschab

  5. Department of Medicine, University of Zimbabwe College of Health Sciences, MP 167, Mount Pleasant, Harare, Zimbabwe

    Margaret Borok

  6. Lineberger Comprehensive Cancer Center, 101 Manning Drive, 7305, Chapel Hill, NC, 27514, USA

    Matthew Painschab

  7. Global Oncology Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., D5-310, Seattle, WA, 98109, USA

    Thomas S Uldrick

  8. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Thomas S Uldrick

  9. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Thomas S Uldrick & Rachel A Bender Ignacio

  10. Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA

    Rachel A Bender Ignacio

  11. Harborview Medical Center, 325 9th Ave, 359929, Seattle, WA, 98104, USA

    Rachel A Bender Ignacio

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  1. Michalina A Montaño
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  2. Maganizo B Chagomerana
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  4. Matthew Painschab
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  5. Thomas S Uldrick
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Correspondence to Michalina A Montaño.

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Conflict of Interest

Thomas Uldrick has received support for his research from Roche, Merck, and Celgene/BMS, consulting fees from Seattle Genetics and AbbVie, and has a patent related to Kaposi’s sarcoma treatment. Maganizo Chagomerana, Margaret Borok, Matthew Painschab, Michalina Montaño, and Rachel Bender Ignacio declare that they have no conflicts of interest.

Human Rights and Informed Consent

This review article includes two studies performed by Matthew Painschab. These studies were performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all participants.

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This article is part of the Topical Collection on HIV Pathogenesis and Treatment

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Montaño, M.A., Chagomerana, M.B., Borok, M. et al. Impact of Antiretroviral Therapy on Cancer Treatment Outcomes among People Living with HIV in Low- and Middle-Income Countries: a Systematic Review. Curr HIV/AIDS Rep 18, 105–116 (2021). https://doi.org/10.1007/s11904-021-00542-5

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