People with HIV continue to experience higher rates of both AIDS-defining and non-AIDS cancers in the era of effective antiretroviral therapy (ART), according to a report in the February 20, 2014, issue of AIDS. Increased longevity alone does not explain the rise in non-AIDS cancer rates, and further research is needed on the causes and best treatments for cancer in this population, the study authors concluded.
The incidence of AIDS-defining cancers — that is, Kaposi sarcoma, primary central nervous system lymphoma, non-Hodgkin lymphoma, and cervical cancer — have declined dramatically, by more than 70%, since the advent of effective combination ART, but HIV positive people still have higher rates than the general population, Paul Rubinstein from Rush University Medical Center in Chicago and colleagues wrote.
While survival of newly infected people with HIV “now rivals that of the general population,” morbidity and mortality associated with non-AIDS-defining cancers such as lung cancer, liver cancer, anal cancer, and melanoma skin cancer “are significant and also continue to rise.” In industrialized countries the number of cases of non-AIDS cancers now equals or exceeds those of AIDS-defining cancers.
Anal cancer is caused by the same human papillomavirus (HPV) strains as cervical cancer, and some experts believe it should also be considered AIDS-related. Liver disease, often due to chronic hepatitis B or C, is a growing cause of morbidity and mortality among people with HIV in the ART era, and these viruses can cause liver cancer.