HIV-related Cancers Decreased Due To ART

Certain cancer risks in HIV patients in the US have been reduced due to the emergence of antiretroviral therapies (ART) in the last 20 years.

A new study has found that several virus-related cancers, as well as lung cancer, have declined in risk since 1996 — when ART was expanded in HIV therapy regimens. The result is an indication of improved patient care, as well as a change in the prevalence of risk factors caused by HIV patients.

Particular cancers, including Kaposi sarcoma, lymphomas, and cervical, anal, and liver cancers, have been known to have an elevated presence in HIV patients for a long time, study lead author Raul Hernandez-Ramirez, MSc, told MD Magazine.

“Incidence of Kaposi sarcoma and non-Hodgkin lymphoma have dramatically declined since the introduction of effective antiretroviral therapy in 1996,” Hernandez-Ramirez, a PhD student at the Yale University School of Public Health, said. “However, trends for other cancers have been less clear, and studies covering years in the more modern treatment era are scarce.”

Hernandez-Ramirez pointed to HIV’s effect on patient immunosuppression — as well as an increased prevalence of cancer-causing viruses, smoking, and alcohol use — as contributive to the elevated cancer risks in HIV patients.

In a study of US population-based HIV and cancer registries, researchers assessed 448,258 HIV patients identified in Colorado, Connecticut, Georgia, Maryland, Michigan, New York, Puerto Rico, and Texas from 1996 to 2012. From that population, 21,294 (4.75%) incident cancers were documented in that time — an increase from the general population, according to calculated standardized incidence ratios (SIRs).

The increased cancer patient rate was particularly higher versus non-HIV population for incidences of Kaposi’s sarcoma, non-Hodgkin lymphoma, virus-related cancers, and lung cancer.

In tracking the difference over 2 decades with multivariable adjustments, researchers found elevated risks in several cancers after AIDS onset. However, SIRs “decreased significantly” for Kaposi’s sarcoma, 2 subtypes of non-Hodgkin lymphoma, and cancers of the anus, liver, and lung.