Acquired immunodeficiency syndrome and related malignancies: a topical overview

As we enter the second decade of confronting human immunodeficiency virus (HIV)-induced disease, progress in the prophylaxis and treatment of acquired immunodeficiency syndrome (AIDS)-related opportunistic infections is encouraging. While the infectious manifestations of HIV become more manageable, AIDS-related malignancies remain problematic. In the era of infection prophylaxis and antiretroviral therapy, the incidence of Kaposi's sarcoma (KS) and aggressive non-Hodgkin's lymphoma (NHL) appears to be increasing. Mounting evidence suggests that KS may result from infection with an as yet unidentified sexually transmitted agent. The increase in NHL cases may result from patients surviving longer with severe immune compromise with a possible contribution of antiretroviral therapy itself. Despite effective cosmetic treatments, survival in recently diagnosed KS patients is actually shorter than patients diagnosed with KS earlier in the epidemic. The addition of growth factors to the chemotherapeutic regimen of patients with AIDS-related NHL has not yet been translated into a survival advantage. In vitro antiviral activity and clinical evidence of possible synergy with other antiretrovirals suggests that continued investigation of alpha-interferon in treatment of AIDS-related malignancies is a priority for the second decade of challenging AIDS.