What types of cancers are associated with immune suppression in HIV? Lessons from solid organ transplant recipients.
OBJECTIVE
To examine recently published evidence of cancer risk after solid organ transplantation to gain insight into cancers that are associated with immune suppression in HIV.


RESULTS
Data from several population-based studies comparing cancer risk in recipients of solid organ transplants with that in the general population have demonstrated increased risk for a broad range of cancers, predominantly those with a known or suspected infectious cause. This increase in risk is independent of cohort aging and probably independent of established behavioral and other risk factors for cancer. Epidemiological risk factor data are limited but appear to indicate a relationship with severity and duration of immune suppression. A recent meta-analysis indicates a striking similarity in the pattern of cancer occurrence in transplant recipients and people with HIV/AIDS.


CONCLUSIONS
The similarity of the increased risk of cancer in these two immunosuppressed populations, who differ with respect to their underlying conditions and lifestyles, is compelling evidence that these cancers are associated with immune deficiency. The mechanisms are not fully understood but appear to be related to impaired immune surveillance. These data challenge the classification of only a narrow range of cancers as associated with immune suppression in people with HIV/AIDS.
Vajdic
Claire M
CM
Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Level 1 SouthWing Edmund Blacket Building, Prince of Wales Hospital, Randwick, NSW 2031, Australia. claire.vajdic@unsw.edu.au
van Leeuwen
Marina T
MT