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Antiretroviral therapy may prevent some cancers in people with HIV
Medical Study News
2005-03-23
In people infected with human immunodeficiency virus (HIV), highly active antiretroviral therapy (HAART) may prevent most excess cases of Kaposi sarcoma and non-Hodgkin lymphoma, according to a new study in the March 16 issue of the Journal of the National Cancer Institute.
Studies of people with acquired immunodeficiency syndrome
(AIDS) have reported increased risks of several cancers, including
Kaposi sarcoma, non-Hodgkin lymphoma, and, to a lesser extent,
anal cancer, invasive cervical cancer, and Hodgkin lymphoma.
However, less well understood are the associations of these cancer
risks with the use of HAART, with immune status, and with
behavioral risk factors such as smoking.
To estimate excess cancer risk in people infected with HIV and
investigate the modifying effects of the use of HAART and
behavioral factors on this cancer risk, Gary M. Clifford, Ph.D.,
of the International
Agency for Research on Cancer in Lyon, France, and colleagues
analyzed data from the Swiss HIV Cohort Study and Swiss cancer
registries on more than 7,300 people infected with HIV.
People with HIV in the study had a highly elevated risk of
Kaposi sarcoma and non-Hodgkin lymphoma. They also had an
increased risk of anal cancer, Hodgkin lymphoma, cervical cancer,
liver cancer, cancer of the lip, mouth, and pharynx, and
non-melanoma skin cancer. People who used HAART had lower risks of
Kaposi sarcoma and non-Hodgkin lymphoma compared with those who
did not use HAART, although even with HAART these tumors occurred
20 times more frequently than they do in the general population
without HIV/AIDS. HAART use was not associated with lower risks of
Hodgkin lymphoma or other cancers. Although people infected with
HIV had increased risks of cancers of the lung, lip, mouth, and
pharynx, no cases of these cancers were found among nonsmokers.
"In conclusion, HAART treatment may prevent excess risk of
[Kaposi sarcoma] and non-Hodgkin lymphoma, but not that of Hodgkin
lymphoma or other non-AIDS-defining cancers," the authors
write. "Focusing on ways to encourage persons infected with
HIV to quit smoking would be effective in reducing lung cancer in
these persons."
In an editorial, Eric A. Engels, M.D., and James J. Goedert,
M.D., of the National Cancer Institute, revisit the history of the
AIDS epidemic and how the knowledge of cancer and immune diseases
has grown since it began. They note that questions remain about
the types and severity of cancers that will appear in coming years
among patients on HAART, who have less severe but prolonged
immunosuppression. "Controlling the epidemic and ameliorating
the suffering of persons living with HIV/AIDS are more urgent than
ever," they write. "Continued study of cancer in people
with HIV/AIDS will redound to give us clues about cancer etiology
to the benefit of all."
Related link:
http://jncicancerspectrum.oupjournals.org/
(Source: Medical Study News, March 15, 2005)
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