Incidence and mortality of non-AIDS-defining cancers among people living with HIV: A systematic review and meta-analysis

Yuan, Tanwei; Hu, Yuqing; Zhou, Xinyi; Yang, Luoyao; Wang, Hui; Li, Linghua; Wang, Junfeng; Qian, Han-Zhu; Clifford, Gary M.; Zou, Huachun

doi:10.1016/j.eclinm.2022.101613

Cited by 48 publications

(54 citation statements)

References 135 publications

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“…Immunosuppression is a risk factor for melanoma, BCC and SCC. Populations with compromised immunity at increased risk include organ transplant recipients [ 118 ], those diagnosed with HIV/AIDS (fourfold increased risk of melanoma) [ 119 , 120 ], and those treated for rheumatoid arthritis (~ 1.3-fold increased risk of KC and melanoma) [ 121 ], inflammatory bowel disease (~ 1.5-fold increased risk of KC), and some lymphoproliferative disorders including non-Hodgkin lymphoma and chronic lymphocytic leukaemia (~ twofold increased risk of melanoma) [ 122 ]. In solid-organ transplant recipients the magnitude of the increased risk differs between skin cancer types: the increased risk in a high ambient UV radiation environment is two–threefold for melanoma, six–tenfold for BCC, and as high as 100-fold for SCC [ 123 ].…”

Section: Harms Of Exposure To Uv Radiationmentioning

confidence: 99%

The effects of exposure to solar radiation on human health

Neale

Lucas

Byrne

et al. 2023

Photochem Photobiol Sci

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This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors. Graphical abstract

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Section: Harms Of Exposure To Uv Radiationmentioning

confidence: 99%

The effects of exposure to solar radiation on human health

Neale

Lucas

Byrne

et al. 2023

Photochem Photobiol Sci

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“…Comorbidities, multimorbidity, and geriatric syndromes are pressing issues facing clinical care for people aging with HIV. Age-related comorbid complications among the HIV population span across cardiovascular disease (CVD), metabolic diseases, lung disease, bone diseases, liver cirrhosis, renal disease, neurocognitive and neuropsychiatric disorders, and non-AIDS-defining malignancies [4][5][6][7]. PLWH exhibit significantly fewer comorbid-free healthy years than the general population, and this comorbid disparity widens with age, time from HIV acquisition, and delayed ART initiation [8,9].…”

Section: Quality-of-life Outcomesmentioning

confidence: 99%

Decrypting biological hallmarks of aging in people with HIV

Premeaux

Ndhlovu

2023

Current Opinion in HIV and AIDS

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Purpose of review HIV infection adds further complexity to the heterogenous process of aging. In this focused review, we examine and discuss recent advances to better elucidate mechanisms of biological aging perturbed and accelerated in the context of HIV, particularly among those with viral suppression through the benefits of antiretroviral therapy (ART). New hypotheses from these studies are poised to provide an improved understanding of multifaceted pathways that converge and likely form the basis for effective interventions toward successful aging. Recent findings Evidence to date suggests multiple mechanisms of biological aging impact people living with HIV (PLWH). Recent literature delves and expands on how epigenetic alterations, telomere attrition, mitochondrial perturbations, and intercellular communications may underpin accelerated or accentuated aging phenotypes and the disproportionate prevalence of age-related complications among PLWH. Although most hallmarks of aging are likely exacerbated in the setting of HIV, ongoing research efforts are providing new insight on the collective impact these conserved pathways may have in the aging disease processes. Summary New knowledge on underlying molecular disease mechanisms impacting people aging with HIV are reviewed. Also examined are studies that may facilitate the development and implementation of effective therapeutics and guidance on improving geriatric HIV clinical care.

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“…Although AIDS-defining cancers are on a downward trend, the incidence of non-AIDS-defining cancers has increased and influences morbidity and mortality in patients with HIV [21,22 ▪▪ ]. HIV-positive patients and KTR both have an increased risk for cancer compared with the general population [23].…”

Section: Pretransplant Selection Processmentioning

confidence: 99%

Immunosuppression in HIV-positive kidney transplant recipients

Sorohan

Ismail

Leca

2023

Current Opinion in Organ Transplantation

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Purpose of study The purpose of this review is to provide the current state of immunosuppression therapy in kidney transplant recipients (KTR) with HIV and to discuss practical dilemmas to better understand and manage these patients. Recent findings Certain studies find higher rates of rejection, which raises the need to critically assess the approach to immunosuppression management in HIV-positive KTR. Induction immunosuppression is guided by transplant center-level preference rather than by the individual patient characteristics. Earlier recommendations expressed concerns about the use of induction immunosuppression, especially utilizing lymphocyte-depleting agents; however, updated guidelines based on newer data recommend that induction can be used in HIV-positive KTR, and the choice of agent be made according to immunological risk. Likewise, most studies point out success with using first-line maintenance immunosuppression including tacrolimus, mycophenolate, and steroids. In selected patients, belatacept appears to be a promising alternative to calcineurin inhibitors with some well established advantages. Early discontinuation of steroids in this population carries a high risk of rejection and should be avoided. Summary Immunosuppression management in HIV-positive KTR is complex and challenging, mainly because of the difficulty of maintaining a proper balance between rejection and infection. Interpretation and understanding of the current data towards a personalized approach of immunosuppression could improve management in HIV-positive KTR.

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Incidence and mortality of non-AIDS-defining cancers among people living with HIV: A systematic review and meta-analysis

Cited by 48 publications

References 135 publications

The effects of exposure to solar radiation on human health

The effects of exposure to solar radiation on human health

Decrypting biological hallmarks of aging in people with HIV

Immunosuppression in HIV-positive kidney transplant recipients

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