AACR Study Finds Shift in Cancer Burden in HIV-Positive Individuals

People infected with the human immunodeficiency virus (HIV) are at a much greater risk of developing Kaposi sarcoma, non-Hodgkin lymphoma (NHL), and cervical cancer. It is also an indication that their infection has developed to AIDS. However, researchers at the University of North Carolina at Chapel Hill project a shift toward HIV-infected individuals developing cancers that affect the general population, such as prostate and lung cancer.

The authors used data (2000 to 2012) from the HIV/AIDS Cancer Match Study, which collates information from statewide cancer registries within the United States to understand the patterns of cancer risk among HIV-infected people. The present study estimated cancer incidence rates through 2030 in HIV-infected individuals, based on current trends. For the actual estimation, researchers multiplied the number of people expected to be living with HIV in the United States each year through 2030 by cancer incidence rates.

The study anticipates a growth in the aging population (65 years and older): 20% in 2030, compared with only 4% in 2006. This, combined with improved antiretroviral treatments for HIV has not just increased life expectancy, but also altered the dynamics between AIDS and how it affects tumor growth.

“The widespread use of modern antiretroviral therapies to treat HIV has decreased the risk of some cancers while at the same time dramatically increasing life expectancy,” said lead author Jessica Yasmine Islam, MPH, a doctoral student at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill. “We estimated future cancer risk and burden for the US population living with HIV in order to anticipate their need for cancer prevention, early detection, and treatment.”

In 2010, the study found about 2719 cases of AIDS-defining cancers in a total cohort of 7909 individuals who were HIV-positive and had cancer. By 2030, the total number of individuals who will develop cancer in this population is expected to drop to 6495. Further, AIDS-defining cancers are estimated to see a dramatic drop to 710. A majority of the individuals who had AIDS-defining cancer in 2010 had developed Kaposi sarcoma or NHL, but the authors expect this will change by 2030—prostate, lung, liver, and anal cancer, would be the more common cancers.

Islam explained that newer antiretrovirals reduce immune suppression, which decreases the risk of developing cancers associated with viral infections and immune suppression, such as Kaposi sarcoma and NHL. Plus the fact that these individuals would survive longer increases their risk of developing ageing-associated cancers.

“Targeted cancer prevention, early detection, and control efforts are needed for people living with HIV in the United States,” the authors conclude, “including smoking cessation, treatment of hepatitis C and B viruses, cancer screening, and continued widespread treatment with highly active antiretroviral therapy.”

The study was presented at the 2017 American Association for Cancer Research Annual Meeting in Washington, DC.

Reference

Islam JY, Rosenberg PS, Hall HI, Jacobson EU, Engels EA, Shiels MS. Projections of cancer incidence and burden among the HIV-positive population in the United States through 2030. Presented at the American Association for Cancer Research Annual Meeting, April 5, 2017, Washington, DC.