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Malignancies in HIV/AIDS: from epidemiology to therapeutic challenges

Rubinstein, Paul G.a,b,*; Aboulafia, David M.c,*; Zloza, Andrewb,d

doi: 10.1097/QAD.0000000000000071
Editorial Review

The incidence of AIDS-defining cancers (ADCs) – Kaposi sarcoma, primary central nervous system lymphoma, non-Hodgkin lymphoma, and cervical cancer – although on the decline since shortly after the introduction of HAART, has continued to be greater even in treated HIV-infected persons than in the general population. Although the survival of newly infected people living with HIV/AIDS now rivals that of the general population, morbidity and mortality associated with non-AIDS-defining cancers (NADCs) such as lung, liver, anal, and melanoma are significant and also continue to rise. Increasing age (i.e. longevity) is the greatest risk factor for NADCs, but longevity alone is not sufficient to fully explain these trends in cancer epidemiology. In this review, we briefly review the epidemiology and etiology of cancers seen in HIV/AIDS, and in this context, discuss preclinical research and broad treatment considerations. Investigation of these considerations provides insight into why malignancies continue to be a major problem in the current era of HIV/AIDS care.

aSection of Hematology/Oncology, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research

bDepartment of Internal Medicine, Rush University Medical Center, Chicago, Illinois

cDivision of Hematology and Oncology, Virginia Mason Medical Center, and the Division of Hematology, University of Washington, Seattle, Washington

dDepartment of Immunology/Microbiology, Rush University Cancer Center, Developmental Center for AIDS Research, Rush University Medical Center, Chicago, Illinois, USA.

*Paul G. Rubinstein and David M. Aboulafia contributed equally to the writing of this article.

Correspondence to Paul G. Rubinstein, MD, Section of Hematology/Oncology, John H. Stroger Jr. Hospital of Cook County, 1900W. Polk Street, Suite 755, Chicago, IL 60612, USA. Tel: +1 312 864 7277; fax: +1 312 864 9002; e-mail: prubinstein@cookcountyhhs.org

Received 5 September, 2013

Revised 5 September, 2013

Accepted 5 September, 2013

Copyright © 2014 Wolters Kluwer Health, Inc.