Non-AIDS-defining malignancies among HIV-infected patients in the highly active antiretroviral therapy era.
In the highly active antiretroviral therapy (HAART) era, the incidence of AIDS-defining malignancies (ADMs) has declined significantly. On the other hand, the incidence of other malignancies not known to be associated with immunosuppression (non-ADMs) has not changed and remains significantly higher than in the general population. Some recent controlled studies even suggest that the incidence of selected non-ADMs has increased in the HAART era. These trends warrant a high index of suspicion for malignancies among HIV care providers and a renewed focus on understanding the mechanisms underlying the increased rates. Potential explanations for the higher non-ADM rates include longer survival of patients with HIV on HAART, with only partial immune recovery achieved in most patients; high incidence of human papillomavirus, Epstein-Barr virus, and hepatitis C virus coinfection in patients with HIV infection; and potential oncogenicity of long-term HIV infection or of long-term HAART.
Bedimo
Roger
R
VA North Texas Health Care System and University of Texas Southwestern Medical Center, 4500 South Lancaster Road, Dallas, TX 75216, USA. roger.bedimo@utsouthwestern.edu
D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000150:complications / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006689:Hodgkin Disease / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology*