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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HIV infected people and AIDS patients develop cancer more frequently than the general population. The objective of this study was to evaluate the risk of developing cancer among 15 to 69 year old AIDS patients from two geographic areas: Tarragona and Girona provinces, in north-eastern Spain. We have studied invasive and in situ cancers (for all sites) among 1659 AIDS patients from +/-5 years around the date of their AIDS diagnosis by matching the population-based Cancer Registries with the AIDS Registry covering these populations. The periods used in the linkage were 1981-1998 for Tarragona and 1994-1999 for Girona. Sex and age-standardised incidence ratios (SIRs) of observed-to-expected cancers were calculated by type of cancer as a measure of risk. For selected types of cancers, SIRs were also calculated for HIV exposure category. Compared with the general population, incidence of cancer among AIDS patients (invasive and in situ) increased 22.9 fold in men (n=142) and 21.0 fold in women (n=45). High statistically significant SIRs were found for Kaposi's sarcoma (KS) (male, 486.4; female, 1030.0), non-Hodgkin's lymphoma (NHL) (male, 126.1; female, 192.8) and invasive cervical cancer (41.8). High risks were also found for Hodgkin's lymphoma (31.1), liver cancer (29.4) and lung cancer (9.4) in men, and in situ cervical cancer (24.4) in women. For all non-AIDS defining malignant neoplasms as a group SIRs were 3.4 in men and 2.5 in women. Among men, homo/bisexuality was strongly related to risk of KS and NHL. The rates of cervical cancer, Hodgkin's lymphoma, liver cancer and lung cancer were among the highest ever reported linked to HIV infection. For the cervical cancer this could be attributable to the low incidence of this cancer in the general population and to the high prevalence of intravenous drug users among HIV women and probably due to poor preventive strategies in this population.
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PMID:Cancer incidence in AIDS patients in Catalonia, Spain. 1734 85

The majority of cancers affecting HIV-infected subjects are those established as acquired immunodeficiency syndrome (AIDS)-defining: Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL), and invasive cervical cancer (ICC). However, other types of cancer, such as Hodgkin's disease (HD), anal cancer, lung cancer and testicular germ cell tumors appear to be more common among HIV-infected subjects compared to the general population. While not classified as AIDS-defining, these malignancies have been referred to as AIDS-associated malignancies. The mechanisms by which depressed immunity could increase the risk for cancer are unclear, except for in KS and most subtypes of NHL, where it is strictly associated with a low CD4 count. Although it remains unclear whether HIV-1 acts directly as an oncogenic agent, it may contribute to the development of malignancies through several mechanisms (e.g., infection by oncogenic viruses, impaired immune surveillance, imbalance between cellular proliferation and differentiation). Studies of the effect of highly active antiretroviral therapy (HAART) on the incidence and progression of HIV/AIDS-associated cancers provided contrasting data. While a significant decrease in the incidence of KS has been observed, HAART has not had a significant impact on NHL incidence, particularly systemic NHL, or on ICC, HD, anal cancers and other non-AIDS-defining cancers. Regardless of whether these cancers are directly related to HIV-induced immunodeficiency, treating cancer in HIV-infected patients remains a challenge because of drug interactions, compounded side effects, and the potential effect of chemotherapy on CD4 count and HIV-1 viral load. A better knowledge of viral mechanisms of immune evasion and manipulation will provide the basis for a better management and treatment of the malignancies associated with chronic viral infections.
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PMID:HIV infection and cancer in the era of highly active antiretroviral therapy (Review). 1739 54

Vitamin A deficiency has been commonly observed in patients with tuberculosis. Low serum retinol levels return to normal after antituberculosis treatment even when no supplements are provided. The deficiency of vitamin A observed in patients with tuberculosis might have contributed to the development of tuberculous disease in them. Alternatively, deficiency could be the result of loss of appetite, poor intestinal absorption, increased urinary loss of vitamin A or acute phase reaction in TB. Vitamin A deficiency lowers immunity while vitamin A supplementation reduces morbidity and mortality, particularly from measles and diarrhoea. Vitamin A supplementation also decreases the mortality rate in HIV-infected children and delays the progression of HIV disease in infected subjects. A higher incidence of lung cancer and increased mortality have been observed in smokers after beta-carotene supplementation. Zinc deficiency is also common in tuberculosis, which may impose a secondary vitamin A deficiency. Clinical trials have shown conflicting results regarding the effect of supplementation of vitamin A, alone or with other micronutrients, on time taken to sputum conversion in patients with pulmonary tuberculosis. Supplementation with multiple micronutrients (including zinc) rather than vitamin A alone may be more beneficial in patients with tuberculosis, but clinical trials on such a combination are lacking.
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PMID:Role of vitamin A supplementation in the treatment of tuberculosis. 1755 17

Since 1996, AIDS-related mortality has declined considerably with the introduction of tritherapy (HAART). This decline in mortality has been associated with an increase in the proportion of deaths caused by cancers unrelated to AIDS, particularly lung cancer. The risk of developing lung cancer is higher in the HIV-seropositive population than in the aged-matched general population, undoubtedly because of the high rate of smoking, particularly among drug abusers, but also because of other reasons which remain to be determined. Mean age at the discovery of lung cancer in HIV+ patients is 45 years, and most are symptomatic. The diagnosis is established at a locally advanced or metastatic stage in 75-90% of patients, as in the general population. Adenocarcinoma is the most common histological type. The prognosis is worse in HIV+ patients than in patients with an undetermined HIV status. Evidence on the efficacy and toxicity of chemotherapy is insufficient to draw any conclusions. Surgery remains the treatment of choice for locally advanced disease if allowed by the clinical status and respiratory function. Prospective clinical studies are needed to define a better management strategy for lung cancer in HIV-positive patients.
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PMID:[Lung cancer in HIV-positive patients]. 1767 40

This investigation highlighted the risk of cancer in 8074 HIV-infected people and in 2875 transplant recipients in Italy and France. Observed and expected numbers of cancer were compared through sex- and age-standardised incidence ratios (SIRs) and 95% confidence intervals (CIs). After 15 years of follow-up, the cumulative probability of cancer was 14.7% in transplant recipients and 13.3% in HIV-positives. The SIRs for all cancers were 9.8 in HIV-positives and 2.2 in transplants. Kaposi's sarcoma (SIR=451 in HIV-positives, 125 in transplants) and non-Hodgkin lymphoma (SIR=62 and 11.1, respectively) were the most common cancers. A significantly increased SIR for liver cancer also emerged in both groups. The risk of lung cancer was significantly elevated in heart transplant recipients (SIR=2.8), and of borderline statistical significance in HIV-positive people (95% CI:0.9-2.8). Immune depression entails a two-fold increased overall risk of cancers, mainly related to cancers associated with a viral aetiology.
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PMID:Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe. 1776 27

Since HIV infection and opportunistic infections began to be treated by highly active antiretroviral therapy (HAART), the incidence of cancers, especially lung cancer increased. The clinical course of lung cancer in HIV infected patients is more aggressive, and little is known about its features or management. We retrospectively evaluated 6 cases of lung cancer with HIV infected patients in Tokyo Metropolitan Komagome Hospital. All patients were male and current smokers. Adenocarcinoma, squamous cell carcinoma and small cell carcinoma were observed in 3, 2 and 1, respectively. There were 2 cases each of clinical Stage I, IIIB, and IV were each 2 cases. The range of the CD4 cell count was 52-432/microL. HIV infection was confirmed concurrently with the diagnosis of lung cancer or complications in 5 of 6 patients. Some cases treated for both lung cancer and HIV, had a relatively good clinical course. We suggest that cancer treatment concurrently with HAART may be useful for similar cases. Further experience and study are necessary.
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PMID:[Clinical features of lung cancer HIV-infected patients]. 1792 66

This study examined the impact of controllability of onset (i.e., means of transmission), disease type (HIV and lung cancer), and culture (Kenya and U.S.) on stigmatizing attitudes and goals for supportive communication. Four hundred sixty-four Kenyan students and 526 American students, and 441 Kenyan nonstudents and 591 American nonstudents were randomly assigned to 1 of 12 hypothetical scenario conditions and asked to respond to questions regarding 3 different types of stigmatizing attitudes and 6 types of supportive communication goals with respect to the character in the scenario. Means of transmission had a strong effect on the blame component of stigma, but none on cognitive attitudes and social interaction components. Similarly, although an effect for means of transmission emerged on intention to provide "recognize own responsibility" and "see others' blame" types of support, no effect was evident for most other supportive interaction goals. Although effects for culture were small, Kenyan participants, student and nonstudent alike, were not as quick as American participants to adopt goals of communicating blame in any direction. Implications for measurement of stigma in future research are discussed.
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PMID:The impact of onset controllability on stigmatization and supportive communication goals toward persons with HIV versus lung cancer: a comparison between Kenyan and U.S. participants. 1796 43

Non-AIDS-defining cancers have recently gained more attention, and it appears that several of these cancers may be more common the the HAART era. By most accounts in the literature, the overall risk of non-AIDS-defining cancer in HIV-infected persons is 2 to 3 times that in the general population. In this article, we review the literature on 5 of the most common non-AIDS-defining cancers (Hodgkin disease, anal cancer, hepatocellular carcinoma, oral cancer, and lung cancer) in the pre- and post-HAART periods. It remains unclear whether earlier initiation (CD4+ cell count above 350/microL) of antiretroviral therapy may be beneficial in preventing non-AIDS-defining cancer. Further large-scale, randomized, prospective studies on this question are warranted.
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PMID:Non-AIDS-defining cancers: should antiretroviral therapy be initiated earlier? 1824 Apr 50

The effect of the evolving HIV epidemic on cancer has been sparsely documented in Africa. We report results on the risk of cancer associated with HIV-1 infection using data from an ongoing study. A case-control analysis was used to estimate the relative risk (odds ratio, OR) of cancer types known to be AIDS defining: Kaposi's sarcoma (n = 333), non-Hodgkin lymphoma (NHL, n = 223) and cancers of the cervix (n = 1,586), and 11 cancer types possibly associated with HIV infection: Hodgkin lymphoma (n = 154), cancers of other anogenital organs (n = 157), squamous cell cancer of the skin (SCC, n = 70), oral cavity and pharynx (n = 319), liver (n = 83), stomach (n = 142), leukemia (n = 323), melanoma (n = 53), sarcomas other than Kaposi's (n = 93), myeloma (n = 189) and lung cancer (n = 363). The comparison group comprised 3,717 subjects with all other cancer types and 682 subjects with vascular disease. ORs were adjusted for age, sex (except cervical cancer), year of diagnosis, education and number of sexual partners. Significantly increased risks associated with HIV-1 infection were found for HIV/AIDS associated Kaposi's sarcoma (OR = 47.1, 95% CI = 31.9-69.8), NHL (OR = 5.9, 95% CI = 4.3-8.1) and cancer of the cervix (OR = 1.6, 95% CI = 1.3-2.0); Hodgkin's disease (OR = 1.6, 95% CI = 1.0-2.7), cancers of anogenital organs other than the cervix (OR = 2.2; 95% CI = 1.4-3.3) and SCC (OR = 2.6, 95% CI = 1.4-4.9) were also significantly increased. No significant associations were found between HIV and any of the other cancers examined. Risks for HIV-related cancers are consistent with previous studies in Africa, and are lower when compared to those observed in developed countries.
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PMID:The spectrum of human immunodeficiency virus-associated cancers in a South African black population: results from a case-control study, 1995-2004. 1824 Oct 34

The AIDS epidemic has had a devastating global impact in the last two decades; although prevalence rates are low in Asia and the Pacific, their enormous population is associated with an estimated 1 million people infected with HIV in 2006 alone. Survival from what had been a uniformly fatal illness has improved markedly with combination antiretroviral therapy and restoration of the immune system, but these treatments are expensive and difficult to distribute to the millions who need them around the world. In addition, millions more do not know they are infected with HIV until they develop an opportunistic infection. The lungs are the most frequent sites of these infections, and in different geographic regions, tuberculosis, bacterial pneumonia and Pneumocystis jiroveci are the dominant pathogens. The incidences of lung cancer and HIV-associated pulmonary arterial hypertension are also increasing in patients with HIV infection, and with the use of antiretrovirals, inflammatory disorders associated with immune restoration are being recognized.
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PMID:Pulmonary complications of HIV infection. 1833 15


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