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and Hepatitis.com Coverage of the
XVIII International AIDS Conference (AIDS 2010) July 18 - 23, 2010, Vienna, Austria
People with HIV Develop Non-AIDS Cancers Earlier and More Often, despite Antiretroviral Therapy
over the past several years has revealed elevated rates of non-AIDS-defining
cancers -- that is, all malignancies except Kaposi's sarcoma, non-Hodgkin
lymphoma (NHL), and cervical cancer -- in the HAART
era, though different studies have produced conflicting findings
concerning which specific cancers occur more often.
In the first study presented at AIDS 2010, Eric Engels from the National Cancer Institute and colleagues estimated the number of cancers occurring over time among people with HIV in the U.S.
Antiretroviral therapy has greatly reduced incidence of AIDS-defining cancers, the researchers noted as background, but as HIV positive people survive longer, there is more time for development of progressive cancers that typically occur at older ages.
Investigators compared rates of cancer among HIV positive and HIV negative individuals. Cancer incidence rates were determined by linking Centers for Disease Control and Prevention (CDC) HIV/AIDS data and cancer registries in 15 U.S. areas.
For people with AIDS, cancer numbers were estimated for 1991-2005 by applying cancer incidence rates to the U.S. population with AIDS based on year, age, sex, race/ethnicity, HIV transmission category, and time since AIDS diagnosis. For HIV positive people without AIDS, cancer counts were estimated for 2004-2007 by applying overall cancer rates for 1998-2005 to HIV cases from 34 states with confidential name-based HIV reporting since 2004.
Based on these findings, the researchers concluded, "Dramatic increases in non-AIDS-defining cancers among persons with AIDS are driven by growth and aging of the AIDS population, and rising incidence rates for some cancers."
"Cancer prevention and treatment in HIV-infected persons are increasingly important," they added.
Cancer at Younger Age
The second study, presented by Minh Ly Nguyen from Emory University School of Medicine, evaluated the age at cancer diagnosis and standardized incidence ratios (SIRs) for various cancers among people with HIV at an Atlanta clinic. These were then compared rates for the general population based on data from the CDC's Surveillance, Epidemiology and End Results (SEER) cancer registries, matched for age, sex, and race/ethnicity.
This retrospective analysis included data from 8300 patients seen at a Ryan White-funded urban HIV clinic in Atlanta between 2000 and 2007. About 75% were men, most were black, and the average age was about 39 years. The researchers did not have adequate data on potential risk factors such as smoking.
findings led the investigators to conclude, "Many non-AIDS-defining
cancers occur at an increased rate compared to the general population
and at an earlier age."
"Cancer screening in HIV-infected patients should be considered at an earlier age than in the general population," Nguyen recommended.
R Pfeiffer, M Gail, E Engels, and others. The burden of cancer among
HIV-infected persons in the U.S. population. XVIII International AIDS
Conference (AIDS 2010). Vienna, July 18-23, 2010. Abstract