Screening for Cancer in Persons Living with HIV Infection

Abstract

Survival with human immunodeficiency virus (HIV) infection has greatly improved due to effective antiretroviral therapy (ART). As infectious complications have declined, malignancy now accounts for over one-third of deaths among people living with HIV (PLWH). Based on practices in the general population, cancer screening of PLWH can decrease both morbidity and mortality. In this article, we review and consider directed approaches for colorectal, breast, cervical and lung cancer screening. Furthermore, routine physical examinations may detect lymphomas and skin, anal and oral cancers. Comprehensive cancer prevention in PLWH should also include ART adherence, vaccination against oncogenic viruses, treatment of hepatitis viruses and smoking cessation. Cancer screening for PLWH warrants further research on safety and efficacy as well as targeted efforts to increase adherence.

Specific nutritional infections early in life as risk factors for human colon and breast cancers several decades later

“…Immunosuppression, in particular when induced by human immunodeficiency virus (HIV) infections, provided an answer: prior to the introduction of the highly active anti‐retroviral therapy (HAART) follow‐up studies claimed a reduced risk for breast cancer in HIV‐infected women (reviewed in Refs. 96,97). After successful HIV‐therapy, the risk for these cancers, as well as for prostate cancer remained comparable to the non‐HIV‐infected population.…”

Cause‐specific mortality after diagnosis of cancer among HIV‐positive patients: A collaborative analysis of cohort studies

“…Mortality rates after diagnosis of cancer were lower during 2006-2015 than 1996-2005: these declines were not explained by changes in CD4 count and viral load at cancer diagnosis. Possible explanations are earlier cancer stage at diagnosis due to improvements in screening, 29 improvements in care among PLHIV, 7,30 greater awareness of drug-drug interactions, 31 availability of more effective treatment for cancer 32 or patients with higher CD4 counts being able to withstand more doses of chemotherapy. 33 The most common cancers reported were the ADMs Kaposi's sarcoma, non-Hodgkin's lymphoma, and cervical cancer and the NADMs lung cancer, Hodgkin's lymphoma, anal cancer, head and neck cancers and liver cancer.…”

Cancer survival in people with AIDS: A population‐based study from São Paulo, Brazil

“…The assessment and the implementation of specific screening guidelines for this population as an attempt to ensure early cancer diagnosis should be also considered. As proposed by Goedert et al ., physical examination of HIV‐infected patients during routine appointments could be a tool to detect some malignancies . In addition to that, efforts to ensure proper cancer treatment in this population should also be emphasized.…”

“…As proposed by Goedert et al, physical examination of HIV-infected patients during routine appointments could be a tool to detect some malignancies. 39 In addition to that, efforts to ensure proper cancer treatment in this population should also be emphasized.…”