HIVers Likely to Develop Cancers

The cumulative incidence of non-AIDS-defining cancers is approaching that of AIDS-defining cancers among HIV patients in settings where antiretroviral therapy is common, according to a consortium of researchers. Their report will be presented at the 2010 American Society of Clinical Oncology Annual Meeting in Chicago, June 4-8.

"We're seeing high rates of head and neck cancer, lung cancer, kidney cancer, liver cancer, and anal cancer," said John F. Deeken, the report's coauthor and director of head and neck oncology at Georgetown University Medical Center. The study also found marked increases in Hodgkin's lymphoma.

"Even when we control for smoking, we see a higher rate than the general population," Deeken said. "We don't know why this is happening. We need to figure that out."

Deeken and colleagues have launched the first clinical trial to study interactions between antiretrovirals and chemotherapy, with the hope formulating treatment recommendations.

The high incidence of non-AIDS-defining cancers among HIV-infected people has been noted for years in separate studies. Activists say the availability of effective treatments has led some in high-risk populations to discount the danger of HIV; that perception might change if the virus began to be associated with cancer.

"The pills have side effects," said Robert Yarchoan, chief of the HIV and AIDS malignancy branch of the National Cancer Institute. "There's premature aging and heart attacks. And now there are these cancers."

Many doctors are not aware that HIV patients are more susceptible to non-AIDS-defining cancers, Yarchoan said. Until recently, HIV patients were excluded from clinical trials for non-AIDS-defining cancers because of their weakened immune systems, but the National Cancer Institute has led efforts to include them, he said.