The effect of non-AIDS-defining cancers on people living with HIV

Lancet Oncol. 2021 Jun;22(6):e240-e253. doi: 10.1016/S1470-2045(21)00137-6.

Abstract

Non-AIDS-defining cancers are a growing source of morbidity for people with HIV globally. Although people living with HIV have a disproportionately increased risk of developing virally mediated cancers, cancer burden for common non-AIDS-defining cancers that are not virally associated and are linked to ageing, such as prostate cancer, is becoming higher than for virally mediated cancers. Ageing, behavioural, and HIV-specific factors drive the incidence and affect the outcomes of non-AIDS-defining cancers, presenting different challenges for addressing global morbidity and mortality from non-AIDS-defining cancer. Although large population-based studies have shown that people living with HIV with non-AIDS-defining cancers have poorer cancer outcomes than do people without HIV, current guidelines emphasise that people living with HIV with non-AIDS-defining cancers should receive standard, guideline-based treatment, and infectious disease and oncology providers should work closely to address potential drug interactions between antiretroviral therapy and antineoplastic treatment. Most trials target preventive measures focusing on non-AIDS-defining cancers. However, treatment trials for the optimal management of people living with HIV and non-AIDS-defining cancer, including interventions such as immunotherapies, are needed to improve non-AIDS-defining cancer outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Acquired Immunodeficiency Syndrome / epidemiology
  • Acquired Immunodeficiency Syndrome / therapy*
  • Antiretroviral Therapy, Highly Active
  • HIV / pathogenicity
  • HIV Infections / epidemiology
  • HIV Infections / therapy*
  • HIV Infections / virology
  • Humans
  • Immunotherapy / standards
  • Neoplasms / epidemiology
  • Neoplasms / etiology
  • Neoplasms / therapy*
  • Risk Factors
  • Sarcoma, Kaposi / epidemiology
  • Sarcoma, Kaposi / etiology
  • Sarcoma, Kaposi / pathology
  • Sarcoma, Kaposi / therapy*
  • Treatment Outcome

Supplementary concepts

  • Non-AIDS-related Kaposi sarcoma