People infected with HIV have a substantially higher risk of
some types of cancer compared with uninfected people of the same age, says Dr
Avron Urison of AllLife.
Three of these cancers are known as “acquired
immunodeficiency syndrome (AIDS) defining cancers” or “AIDS-defining
malignancies”: Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer. A
diagnosis of any one of these cancers marks the point at which HIV infection
has progressed to Aids.
People infected with HIV are several thousand times more
likely than uninfected people to be diagnosed with Kaposi sarcoma, at least 70
times more likely to be diagnosed with non-Hodgkin lymphoma, and, among women,
at least 5 times more likely to be diagnosed with cervical cancer.
In addition, people infected with HIV are at higher risk of
several other types of cancer. These other malignancies include anal, liver,
and lung cancer, and Hodgkin lymphoma.
Higher risk for anal
People infected with HIV are at least 25 times more likely
to be diagnosed with anal cancer than uninfected people, 5 times as likely to
be diagnosed with liver cancer, 3 times as likely to be diagnosed with lung
cancer, and at least 10 times more likely to be diagnosed with Hodgkin
People infected with HIV do not have increased risks of
breast, colorectal, prostate, or many other common types of cancer. Screening
for these cancers in HIV-infected people should follow current guidelines for
the general population.
The connection between HIV/AIDS and certain cancers is not
completely understood, but the link likely depends on a weakened immune system.
Most types of cancer begin when normal cells change and grow uncontrollably,
forming a mass called a tumor.
A tumor can be benign (non-cancerous) or malignant
(cancerous, meaning it can spread to other parts of the body). The types of
cancer most common for people with HIV/AIDS are described in more detail below.
Kaposi sarcoma is a type of skin cancer that has
traditionally occurred in older men of Mediterranean descent, young men in
Africa, or people who have had organ transplantation. Kaposi sarcoma in people
with HIV is often called epidemic Kaposi sarcoma. HIV/AIDS-related Kaposi
sarcoma causes lesions to arise in more than one area of the body, including
the skin, lymph nodes, and organs such as the liver, spleen, lungs, and digestive
Non-Hodgkin lymphoma (NHL) is a cancer of the lymph system.
Lymphoma begins when cells in the lymph system change and grow uncontrollably,
which may form a tumor.
Cervical cancer starts in a woman's cervix, the lower,
narrow part of the uterus. The uterus holds the growing fetus during pregnancy.
The cervix connects the lower part of the uterus to the vagina and, with the
vagina, forms the birth canal. Cervical cancer is also called cancer of the
Other types of cancer
Other, less common types of cancer that may develop in
people with HIV/AIDS are Hodgkin lymphoma, angiosarcoma (a type of cancer that
begins in the lining of the blood vessels), anal cancer, liver cancer, mouth
cancer, throat cancer, lung cancer, testicular cancer, colorectal cancer, and
types of skin cancer including basal cell carcinoma, squamous cell carcinoma,
Taking HAART (highly active antiretroviral therapy), as
indicated based on current HIV treatment guidelines, lowers the risk of Kaposi
sarcoma and non-Hodgkin lymphoma and increases overall survival. Although HAART
has led to reductions in the incidence of Kaposi sarcoma and non-Hodgkin
lymphoma among HIV-infected individuals, it has not reduced the incidence of
cervical cancer, which has essentially remained unchanged.
Moreover, the incidence of several other cancers,
particularly Hodgkin lymphoma and anal cancer, has been increasing among
HIV-infected individuals since the introduction of HAART. The influence of
HAART on the risk of these other cancer types is not well understood.
HIV positive and
The cancer prognosis for people infected with HIV tends to
be worse compared to HIV negative cancer patients, regardless of the type of
malignancy. Perhaps because of a suppressed immune system and impaired immune
surveillance, malignancies take a more aggressive clinical course in those
infected with HIV.
HIV positive patients typically present with more advanced
cancer at the time of diagnosis, and the average age at diagnosis is usually
younger in HIV positive patients compared to HIV negative patients.
This is particularly true with lung and testicular cancers.
In addition, regardless of whether these cancers are directly related to
HIV-induced immunosuppression, treating cancer in HIV positive patients remains
a challenge because of drug interactions, compounded side effects, and the
potential effect of chemotherapy on CD4 cell count and viral load.
Moreover, treatment compliance tends to be poor among HIV
positive patients with cancer, perhaps because of the increased responsibility
of taking drugs for both diseases. The question of whether to suspend HAART
during chemotherapy depends on several factors, particularly the type and stage
of malignancy and the status of HIV infection.
Therefore, individuals living with HIV should at their
regular visits with their healthcare providers undergo correct screening for
early detection of cancer and malignancy.