Overview of the epidemiology of malignancy in immune deficiency.
Immune-suppressed populations experience higher rates of cancer than expected. The most common malignancies are non-Hodgkin's lymphoma (NHL) in those with HIV infection, in organ transplant recipients, and in those with primary immune deficiencies; Kaposi's sarcoma (KS) in those with HIV infection; and nonmelanoma skin cancer (SC) in transplant patients. These cancers are associated with infection with the Epstein-Barr virus (EBV) in NHL, human herpesvirus type 8 (HHV-8) in KS, and the human papillomaviruses (HPV) in SC. The strength of the association varies from very strong (HHV-8 in KS) to inconsistent (HPV in SC). In HIV infection, the risk of these cancers increases quite gradually (within a few years in almost all of the primary immune deficiencies), whereas this risk increases quite quickly among transplant recipients. Comparing the patterns of malignancy and immune parameters among these immune-incompetent populations and the general population may elucidate the role of host response in controlling latent oncogenic infections.
Mueller
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Harvard School of Public Health, Boston, Massachusetts 02115, USA.
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D004854:Herpesvirus 4, Human; D019288:Herpesvirus 8, Human; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000821:virology; D016377:Organ Transplantation / Q000009:adverse effects; D027383:Papillomaviridae; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000821:virology