Non-AIDS-defining cancers

As HIV-infected patients are living longer, non-AIDS-defining cancers are increasing in number and now constitute the majority of cancers diagnosed in the HIV-infected population. The excess incidence of Hodgkin lymphoma and head and neck and liver cancers has been increasing among HIV-infected individuals. Breast and lung cancers appear to occur earlier in the HIV-infected population; Hodgkin lymphoma appears to have a later onset, reflecting the fact that most cases in the HIV-infected population are related to Epstein-Barr virus infection, which is generally seen in older rather than younger individuals. Mortality from Hodgkin lymphoma and lung and prostate cancers is higher among HIV-infected individuals than HIV-uninfected individuals. The greater risk of cancer in the HIV-infected population may be due to a number of factors, including more rapid immunosenescence. At a minimum, age- and sex-appropriate cancer screenings should be performed in all HIV-infected patients, and patients should be counseled on measures to reduce cancer risk. This article summarizes a presentation by Ronald T. Mitsuyasu, MD, at the IAS-USA continuing education program held in San Francisco, California, in March 2013.