Evolving epidemiology of HIV-associated malignancies

Abstract

Purpose of review

The purpose of this review is to describe the epidemiology of cancers that occur at an elevated rate among people with HIV infection in the current treatment era, including discussion of the etiology of these cancers, as well as changes in cancer incidence and burden over time.

Recent findings

Rates of Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer have declined sharply in the highly active antiretroviral therapy era, but remain elevated 800-fold, 10-fold and 4-fold, respectively, compared to the general population. Most studies have reported significant increases in liver cancer rates and decreases in lung cancer over time. While some studies have reported significant increases in anal cancer rates and declines in Hodgkin lymphoma rates, others have shown stable incidence. Declining mortality among HIV-infected individuals has resulted in the growth and aging of the HIV-infected population, causing an increase in the number of non-AIDS-defining cancers diagnosed each year in HIV-infected people.

Summary

The epidemiology of cancer among HIV-infected people has evolved since the beginning of the HIV epidemic with particularly marked changes since the introduction of modern treatment. Public health interventions aimed at prevention and early detection of cancer among HIV-infected people are needed.