Cancers in People with HIV and AIDS

Yarchoan, Robert

doi:10.1007/978-1-4939-0859-2

Cited by 2 publications

References 696 publications

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HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

Muturi

Mwanzi

Riunga

et al. 2023

JCO Global Oncology

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PURPOSE Antiretroviral therapy (ART) has resulted in a higher life expectancy of persons living with HIV. This has led to an aging population at risk for both non–AIDS-defining cancers (NADCs) and AIDS-defining cancers (ADCs). HIV testing among patients with cancer in Kenya is not routinely performed, making its prevalence undefined. The aim of our study was to determine the prevalence of HIV and the spectrum of malignancies among HIV-positive and HIV-negative patients with cancer attending a tertiary hospital in Nairobi, Kenya. MATERIALS AND METHODS We conducted a cross-sectional study between February 2021 and September 2021. Patients with a histologic cancer diagnosis were enrolled. Demographic data and HIV- and cancer-related clinical variables were obtained. HIV pretest counseling and consent were done, and testing was performed using a fourth-generation assay. Positive results were confirmed using a third-generation assay. RESULTS We enrolled 301 patients with cancer; 67.8% (204 of 301) were female; the mean age was 50.7 ± 12.5 years. From our cohort, 10.6% (95% CI, 7.4 to 14.7, n = 32 of 301) of patients were HIV-positive with the prevalence of a new HIV diagnosis of 0.7% (n = 2 of 301). Of the HIV-positive patients, 59.4% (19 of 32) had a NADC. The commonest NADC was breast cancer (18.8%; 6 of 32), whereas non-Hodgkin lymphoma (18.8%; 6 of 32) and cervical cancer (18.8%; 6 of 32) were the most prevalent ADCs among HIV-positive patients. CONCLUSION The prevalence of HIV infection among patients with cancer was twice the Kenya national HIV prevalence. NADCs comprised a larger percentage of the cancer burden. Universal opt-out HIV testing of patients attending for cancer care regardless of cancer type may facilitate early recognition of HIV-infected patients and aid in appropriate selection of ART and cancer therapies and preventive strategies.

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HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

Muturi

Mwanzi

Riunga

et al. 2023

JCO Global Oncology

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Human Immunodeficiency Virus (HIV) Infection and Cancer

Loarca¹,

Fraietta²,

Pirrone³

et al. 2017

HIV/AIDS - Contemporary Challenges

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Human immunodeficiency virus type 1 (HIV-1) infection confers an increased risk for the development of many cancers. Although the incidences of acquired immunodeficiency syndrome (AIDS)-defining malignancies have declined since the advent of antiretroviral therapy (ART), a number of non-AIDS-defining cancers appear more common in HIV-1-infected individuals relative to the general population. ART-treated HIV-1-infected subjects are also aging, leading to an increased cancer burden in these populations. However, longevity alone is not sufficient to explain these epidemiologic trends. A causative link between HIV-1-induced immune suppression and elevated cancer risk is well defined in certain malignancies; however, the direct role of HIV-1 replication products in oncogenesis remains unclear. Nevertheless, it is evident that cooperation between HIV-1 and co-infecting viruses in targeting immune compartments as well as nonimmune microenvironments can regulate both the development and progression of cancer. Treating cancer in HIV-1-infected patients remains challenging due to drug interactions, compounded side effects and intensified immunosuppression from chemotherapy and/or radiation. While survival of HIV-1-infected patients with certain cancers now rivals that of their uninfected counterparts, a better understanding of HIV-1-induced oncogenesis, viral mechanisms of immune perturbation, nonimmune microenvironmental abnormalities and outcomes of therapy will provide the basis for better diagnosis and management of cancer.

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Cancers in People with HIV and AIDS

Cited by 2 publications

References 696 publications

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

Human Immunodeficiency Virus (HIV) Infection and Cancer

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