Treating Cancer

HIV and Cancer

HIV and Cancer

How has antiretroviral therapy changed the cancer risk of people infected with HIV?

You will learn about high-risk situations here and how you can reduce your chances of getting cancer. But, first, let’s check out the many factors contributing to the increased risk of cancer in Human Immunodeficiency Virus (HIV) patients.

Antiretroviral therapy (ARV) has significantly improved the prognosis of HIV-positive people, but it is still common for them to develop cancer. This is because cancer risk increases as you live longer – just like the general population. There is also a complex interplay between HIV and cancers.

With the advent of highly active antiretroviral therapy (HAART), the incidence of certain cancers has significantly been reduced.

HAART doesn’t completely restore the immune system, which could be one explanation for the persistently high risk. There are AIDS DEFINING CANCERS ADCs and NON-ADCs – NADCs are further classified as virus-related and virus unrelated.

Cancer Incidence

The rate of HIV infection is still growing fast, though.

Cancers in people living with HIV

The viruses that are most likely to cause cancer in people with HIV are1:

  • Kaposi sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), causes Kaposi sarcoma and some subtypes of lymphoma
  • Epstein-Barr virus (EBV) causes some subtypes of non-Hodgkin and Hodgkin lymphoma
  • Human papillomaviruses (HPV), high-risk types of which cause cervical cancer, most anal cancers, and oropharyngeal, penile, vaginal, and vulvar cancer
  • Hepatitis B virus (HBV) and hepatitis C virus (HCV), which both cause liver cancer.
Alcohol use

If you are HIV positive, here are some things you can do to reduce your cancer risk:

Cancer risk factors associated with HIV-1 infection.

The following factors may increase cancer risk in HIV-1-infected individuals: alcohol consumption, smoking, the duration of antiretroviral therapy (ART), a chronic immunoinflammatory state, and/or advanced age.

In HIV-1 infected individuals, complex interactions between ART use, HIV-1 replication, ageing, and other risk factors can influence tumour biology.

  1. Take your HIV medication. Maintaining a higher CD4+ T-cell count can reduce the risk of AIDS-defining cancers and certain forms of lymphoma.
  2. Give up smoking and reduce the risk of lung, oral, throat and other cancers.
  3. HIV-infected people seem to develop liver cancer at a higher rate than HIV-uninfected people. It is, therefore, important that HIV-infected individuals should know their hepatitis status.
  4. Get screened regularly. The risk of cervical cancer in HIV-infected women is higher. Therefore, up to age 26, women and men with HIV are strongly encouraged to be vaccinated against human papillomavirus (HPV). Cervical cancer is preventable through an HPV vaccine administered before HPV exposure, and it is easier to treat if caught early, making screening essential.
  5.  
Comprehensive Cancer Care and treatment

If you have HIV and are diagnosed with cancer, find an oncologist experienced in managing your specific type of cancer and who has experience caring for people with HIV. If you have HIV and are diagnosed with cancer,  find an oncologist experienced in managing your specific type of cancer and experience caring for people living with HIV.

Dr Pillay is an oncologist and an HIV/TB specialist.  Please contact Dr Prinitha Pillay on www.treatingcancer.co.za or email her at reception@treatingcancer.co.za. Dr Pillay is available to her patients from 7am to 7pm Monday to Sunday.

References:

  1. Goncalves PH, Montezuma-Rusca JM, Yarchoan R, Uldrick TS. Cancer prevention in HIV-infected populations. Seminars in Oncology 2016; 43(1):173-188. [PubMed Abstract]