The main AIDS-defining cancers have declined in certain population groups in western Europe since the advent of highly active antiretroviral therapy (HAART), according to a report in the September issue of AIDS Patient Care and STDs.
When HAART was introduced, the authors explain, many believed the extension of life expectancy would increase the proportion of AIDS-defining cancers. Reports from cohort studies and surveillance data have, however, yielded conflicting results.Dr. Francoise F. Hamers from Institut de Veille Sanitaire, France and colleagues used the European Non-Aggregate AIDS Data Set, one of the largest multicountry AIDS databases, to assess trends in AIDS-defining cancers from 1994 through 2001.During this interval, the authors report, the percentage of patients with malignancies as the initial AIDS-defining illness declined among men and increased among women.The percentage of men with Kaposi sarcoma declined significantly among homosexual/bisexual men, the report indicates, whereas the percentage of men with AIDS with lymphomas increased.Among women, cervical cancer rates declined among women between 15 and 29 years old or who acquired HIV heterosexually. Rates did not, however, decrease among intravenous drug users.The percentage of women with AIDS and lymphoma increased significantly, the researchers note, and the percentage with Kaposi sarcoma increased slightly.”Trends in the incidence of AIDS-defining cancers are likely to depend on variations in risk behaviors for carcinogenic viruses, frequency with which HIV infected individuals develop other AIDS-defining conditions, variations in risk for development of opportunistic infections such as tuberculosis, and access to HAART and its utilization,” the investigators write.”Although the magnitude of the risk of the two most common cancers among people with AIDS has reduced,” the authors conclude, “as HAART increases survival of people with AIDS, the risk of developing of dying from some cancers among HIV-infected persons may increase.””Cancers remain an important challenge to clinical management of HIV/AIDS and the quality of life of people with AIDS,” the researchers add.(Source: AIDS Patient Care and STDs 2004;18:501-508: Reuters Health: Oncolink: October 2004.)