2. Definition
Patient's with HIV infection or AIDS have a
substantially increased risk of
developing a number of cancers. Three of
these cancers,
(KS), (NHLs), and cervical cancer, confer
a diagnosis of AIDS when they arise in an
HIV-infected patient and are
referred to as AIDS-defining malignancies
3. HIV increases the risk
for a number of other tumors, including classic
Hodgkin lymphoma (cHL),
lung cancer, anal cancer, oropharyngeal cancer,
hepatocellular carcinoma,
and nonmelanoma skin cancer. These other HIV-
associated tumors are
referred to as non–AIDS-defining malignancies
4.
5. EPIDEMIOLOGY
The standardized incidence ratios of KS and certain
aggressive B-cell NHLs are markedly increased in
patients with HIV, especially those with low CD4
counts. KS,certain NHLs, cervical cancer, and
NADMs are directly or indirectly caused by
oncogenic viruses, especially Kaposi sarcoma
herpesvirus (KSHV, also called [HHV-8]), (EBV),
(HPV), (HCV), (HBV)
6. Overall, cancer is one of the leading causes of death
in HIV-infected patients in countries where cART is
widely available,
because fewer patients are dying from other causes
such as infections associated with low CD4 counts
or AIDS itself. Also, HIV-associated cancers,
especially ADMs, are a major public health concern
in many resource-limited regions, such as
subSaharan Africa.
7.
8. An increased risk of developing neoplasm with HIV
infection over 60 years
Kaposi’s sarcoma 545 times,
non-Hodgkin lymphomas 24.6 times,
lymphogranulomatosis 13.1 times,
colorectal cancer 8.2 times,
leukemia 2.4 times,
lung cancer - 1.9 times
compared with the risk to the population as a whole.
По материалам публикации: В.В.Рассохин,
О.Н.Леонова,О.В.Пантелеева, Н.Л.Смирнова,
Н.В.Фоменкова, З.М.Загдын, Н.А.Беляков.
9. PREVENTION AND SCREENING
Several chemopreventive strategies and behavioral
interventions should be used to prevent HIV
associated malignancies.The risk of KS and NHL in
patients with HIV is decreased with cART Some
studies show that improved immunity with cART also
can reduce the prevalence of premalignant HPV-
associated cervical and anal squamous
intraepithelial neoplasia and lesions.
10. Vaccination against HBV and antiviral therapy against
HBV and HCV decrease the risk of hepatocellular
carcinoma in HIV-uninfected populations. Smoking is
prevalent in many HIV-infected populations, and
smoking cessation interventions are advised.
Nonmelanoma skin cancer is increased with HIV, and
reduction of exposure to ultraviolet radiation is
prudent.HPV vaccines can reduce the risk of HPV
associated cancers and premalignant conditions.They
should optimally be administered in early adolescence
before the onset of sexual activity and exposure to
HPV infection
11. Markedly increased risk of anal cancer in women and
men with HIV, programs have been developed
employing cytologic examination of anal mucosa to
screen for and treat high-grade squamous intraepithelial
lesions (HSIL).National Cancer Institute (NCI) funded
prospective study is planned to evaluate whether this
approach is effective in preventing anal cancer.Routine
recommended cancer screening, such as stool guaiac
examinations or colonoscopy, mammography, and
perhaps low-dose chest computed tomography
(CT)should be offered based on indications for the
general population
12. WHO Classification
current World Health Organization classification
patients with HIV are at substantially increased risk
for eight distinct lymphomas or lymphoproliferative
disorders.we use the term AIDS-related lymphoma
(ARL) to collectively describe the NHLs with
substantially increased standardized incidence ratios
in patients with HIV/AIDS
13.
14. Reference
1.GOLDMAN-CECIL MEDICINE 25TH EDITION Volume I
2. REVIEW ARTICLE HIV-Associated Cancers and Related Diseases Robert
Yarchoan, M.D., and Thomas S. Uldrick, M.D. March 15, 2018 NEJ Med 2018;
378:1029-1041 DOI: 10.1056/NEJMra1615896
3. Based on materials from the publication: V.V. Rassokhin, O.N. Leonova,
O.V. Panteleeva, N.L. Smirnova, N.V. Fomenkova, Z.M. Zagdyn, N.A.
Belyakov.The frequency and nature of cancer in patients with HIV infection
before and during the use of highly active antiretroviral therapy // HIV
infection and immunosuppression. — 2012. — T. 4 — No. 4. — P. 34–43.
