Low CD4 Counts Boost Cancer Risks

HIV-positive men face a high risk for anal intraepithelial neoplasia, a condition that can develop into invasive anal cancer, according to a study in the November 1 issue of Journal of Infectious Diseases. A study of 92 HIV-positive men, most African-American or Latino, showed 9% had high-grade AIN. Although a history of receptive anal sex was a risk factor for AIN and also for infection with human papillomavirus, which has been linked with cancer, the biggest risk factor for AIN was a low nadir CD4-cell count regardless of sexual exposure. The researchers say a relatively intact immune system may provide protection against AIN and help control HPV infection and that the use of antiretrovirals might not offer complete protection for people who began therapy with very low CD4-cell counts. While AIN does carry a risk for developing into anal cancer, most cases do not become cancerous and do respond well to medical treatment, the researchers say.