title: HIV infection, aging, and immune function:  implications for cancer risk and prevention.
abstract: OBJECTIVE
  Combination antiretroviral therapy (ART) has turned HIV infection into a complex chronic disease. This article documents cancer risk among HIV-infected persons, reviews immune system effects of HIV infection in relation to cancer risk, discusses implications for cancer prevention, and suggests future research directions.
  
  
  RESULTS
  There has been a shift in the cancer spectrum from AIDS-defining cancers (ADC) to non-ADC, although the burden of ADC remains high. Although a high prevalence of non-HIV cancer risk factors among HIV-infected persons contributes to cancer risk, substantial evidence has accumulated in favor of an independent association between HIV-induced immunodeficiency and elevated risk of many specific cancer types, most of viral cause, although further work is needed to disentangle immunodeficiency and smoking effects for lung cancer, and immunodeficiency and hepatitis virus effects for liver cancer. Relationships between cancer risk and two other immune system hallmarks of HIV infection, chronic inflammation, and immune dysfunction/senescence, remain poorly understood.
  
  
  CONCLUSIONS
  Early, sustained ART is a crucial component of cancer prevention. Continued epidemiologic monitoring is needed to detect possible effects on cancer risk of specific ART classes or medications, long-term exposure to systemic inflammation or immune dysfunction, or earlier or more effective ART.
authors: Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut, USA. robert.dubrow@yale.edu
authors: Robert
authors: R
authors: Dubrow
authors: Michael J
authors: MJ
authors: Silverberg
authors: Lesley S
authors: LS
authors: Park
authors: Kristina
authors: K
authors: Crothers
authors: Amy C
authors: AC
authors: Justice
mesh_terms: D000367:Age Factors; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D009369:Neoplasms / Q000276:immunology / Q000517:prevention & control* / Q000821:virology*