title: Human immunodeficiency virus-associated malignancies: a therapeutic update.
abstract: Implementation of highly active antiretroviral therapy (HAART) has deeply changed the landscape of HIV-associated malignancies. Some AIDS-defining tumors, namely Primitive Lymphoma of Central Nervous System, have drastically declined, whereas a steady increase has been observed for non-AIDS-defining tumors, maybe due to longer survival of HIV-infected people. Easier immune restoration, subsequent to availability of a number of drugs targeting HIV at different points, has decreased opportunistic infections which hampered treatment of HIV-associated cancers. As a matter of fact these patients have been assimilated more and more with their negative counterpart, undergoing the same aggressive approach. Consistently, procedures that have been so far precluded to HIV+ subjects, such as transplant of hemopoietic stem cells, either autologous or allogenic, and liver transplant are expected to be performed more and more extensively in this population. Which also would mean a full removal of the stigma which has weighed on it. Hence, it is true-like that malignancies and related problems may in the next future make up a main concern for the HIV specialist. Old and new challenges might be the drug-drug interaction of antiretrovirals or biotherapy-related infections or the debated question of an earlier HAART implementation in the course of HIV disease, with CD4+ cells > 500/μl. In fact, if assimilation of HIV patients with cancer and the general population is a remarkable achieved goal, uniqueness of HIV infection in terms of immune status still makes HIV-associated cancer a unique chapter in the setting of Oncology.
authors.affiliation: Department of Infectious Diseases, Unit of Infectious and Tropical Diseases, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Malfitano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbaro
authors.forename: Alessandro
authors.initials: A
authors.lastname: Perretti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Barbarini
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D023241:Antiretroviral Therapy, Highly Active; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy; D009369:Neoplasms / Q000188:drug therapy* / Q000821:virology; D012514:Sarcoma, Kaposi / Q000188:drug therapy