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Non—AIDS–Defining cancers and HIV infection

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Abstract

With fewer patients now succumbing to infectious complications of AIDS, other HIV-related morbidities such as malignancies have become increasingly important. Apart from Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical cancer, which are considered as AIDS-defining, several additional cancers, referred to as non-AIDS-defining cancers, are also statistically increased in HIV-infected persons. These include Hodgkin’s disease, anal carcinoma, lung cancer, nonmelanomatous skin cancer, and testicular germ cell tumors, among others. However, the types of cancer observed at an increased frequency and the relative risks reported vary widely among studies. Although immunosuppression is consistently associated with an increased risk of AIDS-related malignancies, the role of immunosuppression in the pathogenesis of non-AIDSdefining cancers is controversial. Although data regarding the optimal management of these cancers are lacking, current studies suggest that patients with HIV-associated malignancies should be treated with similar approaches to those of their counterparts in the general population.

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References and Recommended Reading

  1. Palella FJ Jr, Delaney KM, Moorman AC, et al.: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998, 329:853–860.

    Article  Google Scholar 

  2. Goedert JJ, Cote TR, Virgo P, et al.: Spectrum of AIDS-associated malignant disorders. Lancet 1998, 351:1833–1829.

    Article  PubMed  CAS  Google Scholar 

  3. Frisch M, Biggar RJ, Engels EA, et al.: AIDS-Cancer Match Registry Study Group. Association of cancer with AIDS-related immunosuppression in adults. JAMA 2001, 285:1736–1745. This large epidemiologic study examining cancer patterns among adults with HIV/AIDS reported an increased risk for HD, testicular seminoma, multiple myeloma, brain cancer, penile cancer, soft tissue malignancies, and lip cancer.

    Article  PubMed  CAS  Google Scholar 

  4. Franceschi S, Dal Maso L, Arniani S, et al.: Risk of cancer other than Kaposi’s sarcoma and non-Hodgkin’s lymphoma in persons with AIDS in Italy. Cancer and AIDS Registry Linkage Study. Br J Cancer 1998, 78:966–970.

    PubMed  CAS  Google Scholar 

  5. Grulich AE, Wan X, Law MG, et al.: Risk of cancer in people with AIDS. AIDS 1999, 13:839–843.

    Article  PubMed  CAS  Google Scholar 

  6. Mbulaiteye SM, Biggar RJ, Goedert JJ, et al.: Immune deficiency and risk for malignancy among persons with AIDS. J Acquir Immune Defic Syndr 2003, 32:527–533.

    Article  PubMed  Google Scholar 

  7. Grulich AE, Li Y, McDonald A, et al.: Rates of non-AIDSdefining cancers in people with HIV infection before and after AIDS diagnosis. AIDS 2002, 16:1155–1161.

    Article  PubMed  Google Scholar 

  8. Ayers KM, Clive D, Tucker WE Jr, et al.: Nonclinical toxicology studies with zidovudine: genetic toxicity tests and carcinogenicity bioassays in mice and rats. Fundam Appl Toxicol 1996, 32:148–158.

    Article  PubMed  CAS  Google Scholar 

  9. Olivero OA, Anderson LM, Diwan BA, et al.: Transplacental effects of 3′-azido-2′,3′-dideoxythymidine (AZT): tumorigenicity in mice and genotoxicity in mice and monkeys. J Natl Cancer Inst 1997, 89:1602–1608.

    Article  PubMed  CAS  Google Scholar 

  10. LARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Some Antiviral and Antineoplastic Drugs, and Other Pharmaceutical Agents. Lyon, France: International Agency for Research on Cancer Scientific Publication No. 76; 2000:35–42, 73–127, 153–173.

  11. Sussman HE, Olivero OA, Meng Q, et al.: Genotoxicity of 3′-azido-3′-deoxythymidine in the human lymphoblastoid cell line, TK6: relationships between DNA incorporation, mutant frequency, and spectrum of deletion mutations in HPRT. Mutat Res 1999, 429:249–259.

    PubMed  CAS  Google Scholar 

  12. Meng Q, Grosovsky AJ, Shi X, et al.: Mutagenicity and loss of heterozygosity at the APRT locus in human lymphoblastoid cells exposed to 3′-azido-3′-deoxythymidine. Mutagenesis 2000, 15:405–410.

    Article  PubMed  CAS  Google Scholar 

  13. Meng Q, Walker DM, Olivero OA, et al.: Zidovudinedidanosine coexposure potentiates DNA incorporation of zidovudine and mutagenesis in human cells. Proc Natl Acad Sci U S A 2000, 97:12667–12671.

    Article  PubMed  CAS  Google Scholar 

  14. Herida M, Mary-Krause M, Kaphan R, et al.: Incidence of non-AIDS-defining cancers before and during the highly active antiretroviral therapy era in a cohort of human immunodeficiency virus-infected patients. J Clin Oncol 2003, 21:3447–3453. This study compared the incidence of non-AIDS-defining cancers in HIV-infected persons before and during the HAART period and found no increase in the overall incidence of non-AIDS-defining cancers between the two periods.

    Article  PubMed  Google Scholar 

  15. Palefsky JM, Holly EA, Ralston ML, et al.: Prevalence and risk factors for human papillomavirus infection of the anal canal in human immunodeficiency virus (HIV)-positive and HIVnegative homosexual men. J Infect Dis 1998, 177:361–367.

    Article  PubMed  CAS  Google Scholar 

  16. Piketty C, Darragh TM, Da Costa M, et al.: High prevalence of anal human papillomavirus infection and anal cancer precursors among HIV-infected persons in the absence of anal intercourse. Ann Intern Med 2003, 138:453–459.

    PubMed  Google Scholar 

  17. Palefsky JM, Holly EA, Ralston ML, et al.: High incidence of anal high-grade squamous intra-epithelial lesions among HIV-positive and HIV-negative homosexual and bisexual men. AIDS 1998, 12:495–503.

    Article  PubMed  CAS  Google Scholar 

  18. Palefsky JM, Holly EA, Hogeboom CJ, et al.: Virologic, immunologic, and clinical parameters in the incidence and progression of anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual men. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 17:314–319.

    PubMed  CAS  Google Scholar 

  19. Minkoff H, Ahdieh L, Massad LS, et al.: The effect of highly active antiretroviral therapy on cervical cytologic changes associated with oncogenic HPV among HIV-infected women. AIDS 2001, 15:2157–2164.

    Article  PubMed  CAS  Google Scholar 

  20. Palefsky JM, Holly EA, Ralston ML, et al.: Effect of highly active antiretroviral therapy on the natural history of anal squamous intraepithelial lesions and anal human papillomavirus infection. J Acquir Immune Defic Syndr 2001, 28:422–428.

    PubMed  CAS  Google Scholar 

  21. Piketty C, Darragh TM, Heard I, et al.: High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy. Sex Transm Dis 2004, 31:96–99.

    Article  PubMed  Google Scholar 

  22. Kiviat N, Redman MW, Hawes SE et al.: The effect HAART on detection of anal HPV and squamous intraepithelial lesions among HIV-infected homosexual men [abstract 1]. Program and Abstracts of the 6th International Conference on Malignancies in AIDS and Other Immunodeficiencies. Bethseda, Maryland: 2002.

  23. Frisch M, Biggar RJ, Goedert JJ: Human papillomavirusassociated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst 2000, 92:1500–1510.

    Article  PubMed  CAS  Google Scholar 

  24. Biggar RJ, Rabkin CS: The epidemiology of AIDS-related neoplasms. Hematol Oncol Clin North Am 1996, 10:997–1010.

    Article  PubMed  CAS  Google Scholar 

  25. Sischy B: The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 1985, 11:1587–1593.

    PubMed  CAS  Google Scholar 

  26. Leichman L, Nigro N, Vaitkevicius VK, et al.: Cancer of the anal canal. Model for preoperative adjuvant combined modality therapy. Am J Med 1985, 78:211–215.

    Article  PubMed  CAS  Google Scholar 

  27. Cleator S, Fife K, Nelson M, et al.: Treatment of HIV-associated invasive anal cancer with combined chemoradiation. Eur J Cancer 2000, 36:754–758.

    Article  PubMed  CAS  Google Scholar 

  28. Peddada AV, Smith DE, Rao AR, et al.: Chemotherapy and low-dose radiotherapy in the treatment of HIV-infected patients with carcinoma of the anal canal. Int J Radiat Oncol Biol Phys 1997, 37:1101–1105.

    Article  PubMed  CAS  Google Scholar 

  29. Gabutti G, Vercelli M, De Rosa MG, et al.: AIDS related neoplasms in Genoa, Italy. Eur J Epidemiol 1995, 11:609–614.

    Article  PubMed  CAS  Google Scholar 

  30. Powles T, Bower M, Daugaard G, et al.: Multicenter study of human immunodeficiency virus-related germ cell tumors. J Clin Oncol 2003, 21:1922–1927.

    Article  PubMed  CAS  Google Scholar 

  31. Bernardi D, Salvioni R, Vaccher E, et al.: Testicular germ cell tumors and human immunodeficiency virus infection: a report of 26 cases. Italian Cooperative Group on AIDS and Tumors. J Clin Oncol 1995, 13:2705–2711.

    PubMed  CAS  Google Scholar 

  32. Timmerman JM, Northfelt DW, Small EJ, et al.: Malignant germ cell tumors in men infected with the human immunodeficiency virus: natural history and results of therapy. J Clin Oncol 1995, 13:1391–1397.

    PubMed  CAS  Google Scholar 

  33. Ricaurte JC, Hoerman MF, Nord JA, et al.: Lung cancer in HIV-infected patients: a one-year experience. Int J STD AIDS 2001, 2:100–102.

    Article  Google Scholar 

  34. Parker MS, Leveno DM, Campbell TJ, et al.: AIDS-related bronchogenic carcinoma. Fact or fiction? Chest 1998, 113:154.

    PubMed  CAS  Google Scholar 

  35. Savès M, Chene G, Ducimetière P, et al.: Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis 2003, 37:292–298.

    Article  PubMed  Google Scholar 

  36. Thompson SC, Nanni C, Levine A: The stressors and stress of being HIV-positive. AIDS Care 1996, 8:5–14.

    Article  PubMed  CAS  Google Scholar 

  37. Bower M, Powles T, Nelson M, et al.: HIV-related lung cancer in the era of highly active antiretroviral therapy. AIDS 2003, 17:371–375.

    Article  PubMed  Google Scholar 

  38. Phelps RM, Smith DK, Heilig CM, et al.: Cancer incidence in women with or at risk for HIV. Int J Cancer 2001, 94:753–757.

    Article  PubMed  CAS  Google Scholar 

  39. Tirelli U, Spina M, Sandri S, et al.: Lung carcinoma in 36 patients with human immunodeficiency virus infection. The Italian Cooperative Group on AIDS and Tumors. Cancer 2000, 88:563–569.

    Article  PubMed  CAS  Google Scholar 

  40. For the WIHS Collaborative Study Group. Cancer risk among participants in the Women’s Interagency HIV Study. J Acquir Immune Defic Syndr 2004, 36:978–985.

    Article  Google Scholar 

  41. Powles T, Bower M: HIV and the risk of lung cancer. J Clin Oncol 2004, 22:1348–1349.

    Article  PubMed  Google Scholar 

  42. de Perrot M, Wigle DA, Pierre AF, et al.: Bronchogenic carcinoma after solid organ transplantation. Ann Thorac Surg 2003, 75:367–371.

    Article  PubMed  Google Scholar 

  43. Sridhar KS, Flores MR, Raub WA Jr, et al.: Lung cancer in patients with human immunodeficiency virus infection compared with historic control subjects. Chest 1992, 102:1704–1708.

    PubMed  CAS  Google Scholar 

  44. Karp J, Profeta G, Marantz PR, et al.: Lung cancer in patients with immunodeficiency syndrome. Chest 1993, 103:410–413.

    PubMed  CAS  Google Scholar 

  45. Fraire AE, Awe RJ: Lung cancer in association with human immunodeficiency virus infection. Cancer 1992, 70:432–436.

    Article  PubMed  CAS  Google Scholar 

  46. Koyi H, Hillerdal G, Branden E: A prospective study of a total material of lung cancer from a county in Sweden 1997–1999: gender, symptoms, type, stage, and smoking habits. Lung Cancer 2002, 36:9–14.

    Article  PubMed  Google Scholar 

  47. Powles T, Thirwell C, Newsom-Davis T, et al.: Does HIV adversely influence the outcome in advanced non-smallcell lung cancer in the era of HAART? Br J Cancer 2003, 89:457–459.

    Article  PubMed  CAS  Google Scholar 

  48. Ames ED, Conjalka MS, Goldberg AF, et al.: Hodgkin’s disease and AIDS. Twenty-three new cases and a review of the literature. Hematol Oncol Clin North Am 1991, 5:343–356.

    PubMed  CAS  Google Scholar 

  49. Spina M, Vaccher E, Nasti G, et al.: Human immunodeficiency virus-associated Hodgkin’s disease. Semin Oncol 2000, 27:480–488.

    PubMed  CAS  Google Scholar 

  50. Re A, Casari S, Cattaneo C, et al.: Hodgkin disease developing in patients infected by human immunodeficiency virus results in clinical features and a prognosis similar to those in patients with human immunodeficiency virus-related non-Hodgkin lymphoma. Cancer 2001, 92:2739–2745.

    Article  PubMed  CAS  Google Scholar 

  51. Bellas C, Santon A, Manzanal A, et al.: Pathological, immunological, and molecular features of Hodgkin’s disease associated with HIV infection. Comparison with ordinary Hodgkin’s disease. Am J Surg Pathol 1996, 20:1520–1524.

    Article  PubMed  CAS  Google Scholar 

  52. Lyter DW, Bryant J, Thackeray R, et al.: Incidence of human immunodeficiency virus-related and nonrelated malignancies in a large cohort of homosexual men. J Clin Oncol 1995, 13:2540–2546.

    PubMed  CAS  Google Scholar 

  53. Dolcetti R, Boiocchi M, Gloghini A, et al.: Pathogenetic and histogenetic features of HIV-associated Hodgkin’s disease. Eur J Cancer 2001, 37:1276–1287.

    Article  PubMed  CAS  Google Scholar 

  54. Carbone A, Gloghini A, Larocca LM, et al.: Human immunodeficiency virus-associated Hodgkin’s disease derives from post-germinal center B cells. Blood 1999, 93:2319–2326.

    PubMed  CAS  Google Scholar 

  55. International Collaboration on HIV and Cancer. Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst 2000, 92:1823–1830.

    Article  Google Scholar 

  56. Monfardini S, Tirelli U, Vaccher E, et al.: Hodgkin’s disease in 63 intravenous drug users infected with human immunodeficiency virus. Gruppo Italiano Cooperativo AIDS & Tumori (GICAT). Ann Oncol 1991, 2(Suppl 2):201–205.

    PubMed  Google Scholar 

  57. Andrieu JM, Roithmann S, Tourani JM, et al.: Hodgkin’s disease during HIV1 infection: the French registry experience. French registry of HIV-associated tumors. Ann Oncol 1993, 4:635–641.

    PubMed  CAS  Google Scholar 

  58. Serrano M, Bellas C, Campo E, et al.: Hodgkin’s disease in patients with antibodies to human immunodeficiency virus. A study of 22 patients. Cancer 1990, 65:2248–2254.

    Article  PubMed  CAS  Google Scholar 

  59. Levine AM, Li P, Cheung T, et al.: Chemotherapy consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine with granulocyte-colony-stimulating factor in HIV-infected patients with newly diagnosed Hodgkin’s disease: a prospective, multi-institutional AIDS clinical trials group study (ACTG 149). J Acquir Immune Defic Syndr 2000, 24:444–450.

    PubMed  CAS  Google Scholar 

  60. Errante D, Gabarre J, Ridolfo AL, et al.: Hodgkin’s disease in 35 patients with HIV infection: an experience with epirubicin, bleomycin, vinblastine and prednisone chemotherapy in combination with antiretroviral therapy and primary use of G-CSF. Ann Oncol 1999, 10:189–195.

    Article  PubMed  CAS  Google Scholar 

  61. Spina M, Gabarre J, Rossi G, et al.: Stanford V regimen and concomitant HAART in 59 patients with Hodgkin disease and HIV infection. Blood 2002, 100:1984–1988.

    Article  PubMed  CAS  Google Scholar 

  62. Hartmann P, Rehwald U, Salzberger B, et al.: BEACOPP therapeutic regimen for patients with Hodgkin’s disease and HIV infection. Ann Oncol 2003, 14:1562–1569.

    Article  PubMed  CAS  Google Scholar 

  63. Goldie SJ, Kuntz KM, Weinstein MC, et al.: The clinical effectiveness and cost-effectiveness of screening for anal squamous intraepithelial lesions in homosexual and bisexual HIV-positive men. JAMA 1999, 281:1822–1829.

    Article  PubMed  CAS  Google Scholar 

  64. Goldie SJ, Kuntz KM, Weinstein MC, et al.: Cost-effectiveness of screening for anal squamous intraepithelial lesions. Am J Med 2000, 108:634–641.

    Article  PubMed  CAS  Google Scholar 

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Lim, S.T., Levine, A.M. Non—AIDS–Defining cancers and HIV infection. Curr Infect Dis Rep 7, 227–234 (2005). https://doi.org/10.1007/s11908-005-0039-4

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