WHat's the link between hiv and cancer?

HIV and CanceR

AIDS is diagnosed in PLWH when the CD4+ T cell count drops below 200 cells/m³, which is considered a dangerously low level that results in such impairment of the immune system that the body is unable to protect itself. Because KS, NHL, and cervical cancer commonly occur in PLWH who likely have low CD4+ T cell counts, they are called AIDS-defining cancers (ADCs). If PLWH are diagnosed with an ADC, they are also diagnosed with AIDS regardless of CD4+ T cell counts. In fact, doctors first recognized the HIV/AIDS epidemic due to an increase in rare infections and cancers like KS that only occur in people with severely impaired immune systems. ADCs occurred at extremely high rates in PLWH in the 80s, 90s, and early 2000s. However, when highly active antiretroviral therapy (HAART) became the standard for HIV treatment, the rates of ADCs significantly dropped. Long-term use of HAART results in undetectable HIV viral loads and normal CD4+ T cell counts, allowing the immune system to function normally. While the rates of ADCs have dropped, there has been a steady increase in the rates of other types of cancer not previously associated with HIV. These cancers are collectively referred to as non-AIDS defining cancers (NADCs), and include Hodgkin lymphoma and cancers of the mouth, throat, liver, lung, and anus.

Cancer Treatment and Outcomes in PLWH

PLWH are not only at increased risk for cancer, they are also more likely to go untreated and die from cancer. This is in part due to misinformation and lack of provider education on cancer in PLWH. At the beginning of the HIV pandemic when there was no available treatment, the virus was a death sentence. Treating cancer in people with uncontrolled HIV was extremely difficult due to their immune compromised state, and the cancer would ultimately prove fatal. Today, however, thanks to HAART, HIV is a manageable illness. Cancer can be effectively treated in PLWH. Guidelines for cancer treatment are largely the same between PLWH and the general population and include standard cancer treatments like chemotherapy, immune therapy, radiation therapy, and surgery. The most notable difference in cancer treatment in PLWH is the need for concomitant HIV management by an HIV specialist. The National Comprehensive Cancer Network (NCCN), which publishes treatment guidelines for doctors caring for cancer patients, has published specific treatment guidelines for cancer in PLWH. It is important that providers stay up to date on cancer treatment in PLWH. It is also important that PLWH undergo appropriate cancer screening to detect cancer at an earlier stage. Ask your doctor about your risk for cancer and what cancer screenings you are eligible for, like Pap smears, mammograms, and colonoscopies. If you are a person living with HIV who has been diagnosed with cancer, ask your doctor about treatment options, NCCN guidelines, and clinical trials you may be eligible for.

people with hiv have poorer cancer outcomes

All data and information provided on www.cancerfreehiv.org comes from peer-reviewed sources. Publications from which data are obtained are listed at the bottom of figures or each page