[Cancer and HIV infection: any association?].
OBJECTIVE
Morbidity and mortality related to neoplasia are increasing in HIV-infected patients. CURRENT KNOWLEDGE AND KEY-POINTS: The incidence of AIDS opportunistic infections dramatically decreased since the introduction of highly active antiretroviral therapy (HAART). Among AIDS-cancers, the incidences of Kaposi sarcoma and of cerebral lymphoma decreased in a same way than AIDS infections but the incidences of systemic non-Hodgkin lymphoma and of cervical cancer decreased less than the others and remain higher than in the general population. This suggests that other factors than the quantitative immune reconstitution could be implicated. The most recent and large studies have also shown a 1.7 to 3 fold increased risk of developing non-AIDS cancers in HIV-infected patients when compared to the general population without significant impact of HAART on incidence curves. These malignancies include Hodgkin disease, lung, anal, head and neck cancers, hemopathies, and conjunctival cancers.


CONCLUSIONS
Epidemiologic survey will help to define priorities in terms of prevention and screening in this specific population and to evaluate interventions which should be systematically proposed (alcohol and tobacco cessation programs, viral coinfection). The own roles of HIV itself and of antiretrovirals as prooncogenic factors need to be assessed.
Bonnet
F
F
Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 1, rue Jean-Burguet, 33075 Bordeaux cedex, France.
Morlat
P
P
D017088:AIDS-Related Opportunistic Infections / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000821:virology; D008175:Lung Neoplasms / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000821:virology; D009369:Neoplasms / Q000453:epidemiology / Q000821:virology*; D012514:Sarcoma, Kaposi / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000821:virology