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[HIV and cancer: Update 2020].

Baptiste Abbar1, Marianne Veyri1, Caroline Solas2

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Summary

Cancer is a leading cause of death for people living with HIV (PLWH). Immune checkpoint inhibitors show promise for treating HIV-associated cancers, with safety and efficacy similar to HIV-negative patients.

Keywords:
CancerDrug interactionsDépistageEpidemiologyHIVImmune checkpoint inhibitorInhibiteurs des checkpoints immunitairesInteractions médicamenteusesNeoplasmScreeningVIHÉpidémiologie

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Area of Science:

  • Oncology
  • Infectious Diseases
  • Public Health

Background:

  • HIV infection is a global health issue, with cancer being the primary cause of mortality in people living with HIV (PLWH) in France.
  • Specific non-AIDS-defining cancers, including anal carcinoma, Hodgkin lymphoma, hepatocellular carcinoma, and lung cancer, are more prevalent in PLWH.
  • Managing HIV-associated cancers requires careful consideration of virological control, oncogenic virus exposure, toxicant exposure, and screening programs.

Purpose of the Study:

  • To review the challenges and advancements in managing cancer in people living with HIV (PLWH).
  • To assess the safety and efficacy of immune checkpoint inhibitors (ICPi) in PLWH.
  • To explore the potential of ICPi for HIV eradication strategies.

Main Methods:

  • Review of clinical data on ICPi use in PLWH.
  • Analysis of safety and efficacy profiles compared to HIV-negative patients.
  • Evaluation of preliminary data on ICPi's "shock and kill" anti-HIV effects.

Main Results:

  • Retrospective data suggest ICPi have a similar safety and efficacy profile in PLWH as in HIV-negative patients, despite initial exclusion from trials.
  • Preliminary "shock and kill" anti-HIV effects of ICPi in PLWH are modest and disappointing.
  • Drug interactions between combined antiretroviral therapies (cART) and cancer treatments necessitate close monitoring.

Conclusions:

  • ICPi represent a viable treatment option for HIV-associated cancers, offering comparable outcomes to the general population.
  • Further research is needed to optimize ICPi therapy and explore its anti-HIV potential.
  • The CANCERVIH national network plays a crucial role in addressing the complex care needs of PLWH with cancer.