HIV-associated malignancies in children.
HIV-infected children are at an increased risk of developing cancer. Many of the cancers in HIV-infected children are linked to immunosuppression and oncogenic coinfections. Worldwide most HIV-infected children live in sub-Saharan Africa, but cancer data for this population are scarce. In this article, we review the current literature on the epidemiology and prevention of cancer in HIV-infected children.



Combined antiretroviral therapy (cART) reduces the risk of developing cancer in HIV-infected children. Cancer risk remains increased in children who start cART at older ages or more advanced immunosuppression as compared with children who start cART at younger age and with mild immunosuppression. Starting cART before severe immunosuppression develops is key to prevent cancer in HIV-infected children but most children in low-income countries start cART at severe immunosuppression levels. Vaccination against high-risk variants of human papillomavirus may protect again human papillomavirus-associated cancer later in life. However, tailoring of human papillomavirus vaccination guidelines for HIV-infected children and young women awaits answers to determine the best vaccination strategies.



Better data on the short-term and long-term risks of developing cancer and the effects of preventive measures in HIV-infected children from regions with high burden of HIV/AIDS are urgently needed.
aNational Cancer Registry, National Health Laboratory Service bPaediatric Haematology Oncology, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa cCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa dInstitute of Social and Preventive Medicine, University of Bern, Switzerland.
Elvira
E
Singh
Gita
G
Naidu
Mary-Ann
MA
Davies
Julia
J
Bohlius
D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D014943:Global Health; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D012307:Risk Factors; D055502:Secondary Prevention
D019380:Anti-HIV Agents
AIDS. 2008 Oct 18;22(16):2165-77
18832880
J Acquir Immune Defic Syndr. 2006 Apr 1;41(4):535-6
16652068
Clin Infect Dis. 2013 Sep;57(5):735-44
23667266
Pediatr Infect Dis J. 2016 Jun;35(6):e164-70
26906162
Pediatr Blood Cancer. 2016 Aug;63(8):1325-31
27082516
Pediatr Blood Cancer. 2009 Apr;52(4):455-8
18802952
AIDS. 2016 May 15;30(8):1245-56
26854809
Lancet HIV. 2016 Oct;3(10):e451-3
27658877
AIDS. 2007 Apr 23;21(7):867-9
17415042
J Acquir Immune Defic Syndr. 2015 Jan 1;68(1):62-72
25501345
Pediatrics. 2015 Jul;136(1):e28-39
26101366
Eur J Cancer. 2014 May;50(8):1472-81
24636877
Semin Oncol. 2016 Feb;43(1):173-188
26970136
J Acquir Immune Defic Syndr. 2014 Apr 1;65(4):463-72
24583616
J Acquir Immune Defic Syndr. 2015 Sep 1;70(1):62-6
26017660
J Natl Cancer Inst. 2015 Jul 16;107(10):
26185193
J Pediatr Hematol Oncol. 2014 Mar;36(2):111-7
24552745
JAMA. 1999 Jan 13;281(2):151-7
9917118
Clin Infect Dis. 2016 Nov 1;63(9):1245-1253
27578823
Lancet. 2007 Jul 7;370(9581):59-67
17617273
Int J Cancer. 2016 Jan 1;138(1):45-54
26175054
Expert Rev Vaccines. 2016;15(1):105-17
26599305
Wkly Epidemiol Rec. 2014 Oct 24;89(43):465-91
25346960
J Acquir Immune Defic Syndr. 2010 Oct;55(2):197-204
20574412
Lancet HIV. 2016 Oct;3(10):e473-81
27658876
Vaccine. 2013 Nov 19;31(48):5745-53
24091311
JAMA. 2000 Nov 22;284(20):2593-2594
11086360
Sex Health. 2014 Dec;11(6):511-23
25218800
Cancer Epidemiol Biomarkers Prev. 2012 Jan;21(1):148-54
22068287
Int J Cancer. 2006 Feb 15;118(4):985-90
16106415
Lancet. 2013 Nov 9;382(9904):1555-63
24209829