Oncological complications of human immunodeficiency virus disease and hematologic consequences of their treatment.
Despite advances in antiretroviral therapy and in the treatment and prevention of opportunistic infections, oncological and consequent hematologic complications of human immunodeficiency virus (HIV) infection continue to occur and are of significant clinical importance. Virus-related tumors (e.g., Kaposi's sarcoma, induced by human herpesvirus 8; non-Hodgkin's lymphoma, linked to Epstein-Barr virus; and anogenital tumors, linked to human papillomavirus) are frequent in patients with HIV-induced immune deficiency. The incidence of AIDS-related Kaposi's sarcoma has declined among homosexual men, but this tumor remains problematic in many patients. Non-Hodgkin's lymphoma is 60 times more prevalent in HIV-positive persons than in others and typically presents as advanced-stage, high- or intermediate-grade B cell lymphoma, with frequent extranodal involvement. Primary central nervous system lymphoma is also common. Cervical carcinoma in HIV-positive women is also usually advanced at diagnosis. Anal carcinoma is increasing in both HIV-positive and HIV-negative populations. Chemotherapy for these tumors can result in dose-limiting cytopenia that can be well-controlled with hematopoietic growth factors, allowing patients to avoid transfusions and maintain the dose intensity of their chemotherapy regimens.
Mitsuyasu
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UCLA Center for Clinical AIDS Research and Education, UCLA, Los Angeles, California 90095-1793, USA.
D000818:Animals; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006402:Hematologic Diseases / Q000209:etiology*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000209:etiology*; D008297:Male; D012514:Sarcoma, Kaposi / Q000209:etiology* / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000209:etiology* / Q000628:therapy; D002578:Uterine Cervical Dysplasia / Q000209:etiology* / Q000628:therapy