Malignant melanoma in HIV: Epidemiology, pathogenesis, and management

Abstract

People affected by immunodeficiency, and especially those infected by HIV, are burdened by a higher risk of developing malignancies. It has been estimated that the incidence of melanoma in HIV-infected people is 2.6-fold higher than in uninfected ones.In this group of patients, melanoma shows a more aggressive phenotype and poorer survival rates compared to HIV-negative people. Standard guidelines of diagnosis and care do not exist yet. Studies suggest high index of suspicion and a low threshold for biopsy in HIV-positive patients regardless of their CD4 + count and the use of standard surgical margins for re-excision procedures. In case of diagnosis of melanoma in HIV-positive patients, a thorough search for metastatic disease is recommended because of the more aggressive course of this cancer in HIV-positive patients. Moreover, to rapidly find out any recurrence or metastatic disease after treatment, these patients need a close follow-up, every 3 months, for the first 2 years and at least twice yearly thereafter. Although surgery remains the main therapeutic option, application of immune checkpoint-based immunotherapy is being studied and seems to be promising. The aim of this review is to present the current knowledge and future options for melanoma diagnosis and treatment in people living with HIV.

Incidence of Skin Cancer in Patients With Chronic Inflammatory Cutaneous Diseases on Targeted Therapies: A Systematic Review and Meta-Analysis of Observational Studies

“…TNF-a exerts several effects. It could promote the progression of cancer (46), but also blocking TNF-a could result in arresting antitumor immune response and in promoting the growth of immunogenic tumors (47)(48)(49).…”

The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa

“…Infection with HIV leads to impaired immunity which might, in turn, result in less effective control of the initiation or progression of skin tumours. Indeed, it is known that CMs in HIV-positive patients are more aggressive and survival rates are poorer than in HIV-negative people [36]. Studies in California demonstrated that there was a greater than two-fold higher incidence of SCC, but not of BCC, in White HIV-positive patients compared with White HIV-negative controls [37,38].…”

<p>LncRNA MALAT1 Promotes the Proliferation, Migration, and Invasion of Melanoma Cells by Downregulating miR-23a</p>

“…1,4 Ultraviolet, race, human immunodeficiency virus, gene, and telomere length are important risk factors for melanoma. [5][6][7][8][9] One of the biggest difficulties in clinical treatment is how to evaluate and predict cancer metastasis and death. 10 Specific biomarkers with high sensitivity are the key to solve this problem.…”