AEGiS-Glasgow [PL7.2] The risk of non-AIDS defining malignancies in the era of highly active antiretroviral therapy (HAART)

Eighth International Congress on Drug Therapy in HIV Infection

Glasgow, UK - 12-16 November 2006

[PL7.2] THE RISK OF NON-AIDS DEFINING MALIGNANCIES IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)

Int Cong Drug Therapy HIV 2006 Nov 12-16;8:Abstract No. PL7.2

Alexandra M Levine
UCL/Norris Cancer Institute, Los Angeles, CA, USA

PURPOSE OF THE STUDY: The use of highly active anti-retroviral therapy (HAART) has resulted in a dramatic decrease in AIDS-defining Kaposi’s sarcoma and non-Hodgkin’s lymphoma, while its impact has been less clear for invasive cervical cancer. Nonetheless, the incidence of several additional cancers, the non-AIDS defining cancers, has also increased statistically in Human Immunodeficiency Virus (HIV) infected individuals. These malignancies include Hodgkin’s lymphoma, anal carcinoma, lung cancer, non-melanomatous skin cancer, and testicular germ cell tumors, among others. Squamous cell carcinoma of the conjunctivae is also increased among African populations. The precise types and relative risks of these cancers vary widely among published studies. Furthermore, the precise role of immunosuppression in the pathogenesis of these malignancies is unclear at this time. While the incidence of lung cancer is increased among HIV-infected persons, the majority of affected individuals have strong histories of cigarette smoking, and only moderate declines in CD4 cells, indicating that HIV itself may not be operative. In the case of Hodgkin’s lymphoma, recent evidence suggests a statistically increased incidence in the era of HAART when compared to pre-HAART periods. This may be related to the fact that the malignant Reed Sternberg cell requires a certain milieu for proliferation and survival; this milieu is induced by the infiltration of CD4 and other inflammatory cells, which may be increased with effective HAART therapy. Although data regarding optimal management of these cancers are sparse, current studies suggest that patients with non-AIDS defining cancers should be treated with similar approaches as those used in HIV-uninfected populations.

Plenary Session: HIV-related Infections, Co-infections and Malignancies II

2006-11-12
PL7.2

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