Is highly active antiretroviral therapy (HAART) associated with change in the risk for cancer in patients with HIV infection?

Bottom line:  Although HIV positive patients are at increased risk for some malignancies, the incidence of the AIDS-defining malignancies has decreased since the advent of HAART.   As to the non-AIDS defining malignancies, incidence for anal cancer and Hodgkin lymphoma have increased, while incidence of other cancers has remained about the same as during the period before HAART.

Details: HIV and Cancer Risk.  National Cancer Institute.
Describes several studies of AIDS and cancer registries reporting decrease in AIDS-related malignancies after the advent of HAART.

Simard EP, et al. Spectrum of cancer risk late after AIDS onset in the United States. Arch Intern Med. 2010 Aug 9;170(15):1337-45.
Reviewed data from 263,254 AIDS patients matched with data from cancer registries in 15 US regions. RESULTS: Fig. 1 shows change in incidence of 4 AIDS-defining malignancies (Kaposi sarcoma, non-Hodgkin lymphoma [NHL], diffuse B-cell NHL & CNS NHL) during 3-10 years after AIDS onset. Incidence decreased for these cancers beginning around 1997, after HAART had been introduced.  Fig. 2  shows change in incidence over time for non-AIDS defining malignancies.  Incidence has increased over time (graph d) for all cancers.  Authors reported analysis showed this could not be attributed only to aging AIDS population.  Authors report an increase in incidence of Hodgkin lymphoma and anal cancer.  Authors reported that when these two cancers were omitted, incidence for other non-AIDS defining malignancies remained the same.

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About Amy

Clinical Informationist at EUH Branch Library
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