Aerodigestive cancers in HIV infection.
OBJECTIVE
Aerodigestive (lung, head and neck) cancers are among the most prevalent and deadly neoplasms worldwide, and the incidence rates are rising. Given the improvements in life expectancy of persons with HIV/AIDS when treated with highly active antiretroviral agents, persons with HIV infection are therefore increasingly likely to develop these malignancies. This chapter focuses on the epidemiology of these malignancies and reviews the most recent literature and current understanding of the causes and treatment of these malignancies in HIV-positive populations.


RESULTS
Aerodigestive neoplasms in patients with HIV infection are associated with younger age at diagnosis, cigarette smoking, advanced stage at presentation, and a more aggressive clinical course. The causes of these cancers, aside from the traditional risk factors of tobacco and alcohol exposure, are not clear. Although these neoplasms are non-AIDS defining, factors that might contribute to risk include HIV-related immunosuppression and co-infection with high-risk human papillomavirus subtypes.


CONCLUSIONS
With continued improvements in therapies for HIV, the expected increase in incidence and mortality of persons with HIV infection from aerodigestive malignancies will likely become a major public health concern. Given the younger age of HIV-infected patients with these malignancies and the apparently higher rates of smoking among HIV-positive individuals, aggressive smoking cessation efforts should be directed to this high-risk population.
Haigentz
Missak
M
Departments of Medicine and Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, 111 East 210th Street, Hoffheimer Room 100, Bronx, NY 10467, USA. mhaigent@montefiore.org
D017668:Age of Onset; D023241:Antiretroviral Therapy, Highly Active; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D016022:Case-Control Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D027383:Papillomaviridae / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation