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

Compared with HIV-negative individuals, HIV-positive individuals have a higher prevalence of anogenital human papillomavirus (HPV) infection, as well as a higher incidence of HPV-associated anal cancer. Little is currently known of chromosomal changes occurring in anal intraepithelial neoplasia (AIN), the probable precursor to anal cancer. Genetic changes in AIN were characterized by comparative genomic hybridization (CGH) in a study of samples obtained from 19 HIV-positive and 11 HIV-negative men. The proportion with genetic changes significantly increased with the severity of the histopathologic grade with none diagnosed as (0%) AIN 1; 5 of 17 (29%) as AIN 2; and 5 of 9 (56%) AIN 3 showing genetic changes (p = .02). This correlation was also found in study subjects who had multiple biopsies with different grades of pathology concurrently or serially over time. The most common regional DNA copy number change was gain mapped to chromosome arm 3q (12% of AIN 2 and 33% of AIN 3). This alteration was previously reported to be commonest alteration in cervical cancer, which suggests a common molecular pathway for these two HPV-associated anogenital neoplasias.
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PMID:Detection of genetic changes in anal intraepithelial neoplasia (AIN) of HIV-positive and HIV-negative men. 1124 98

Anal intraepithelial lesions (ASILs) are considered as precursors of anal cancer. The incidence of high-grade ASIL (HSIL) and progression of low-grade ASIL (LSIL) to HSIL are high in HIV-positive men. Endogenous cytokines, such as interferons (IFNs) play an important role in the regulation of proliferation and immune responses in epithelial cells, and thus, they might control the above-mentioned progression events. Accordingly, we determined mRNA levels of IFN-gamma and IFN-gamma receptors, levels of IFN-gamma receptor-associated kinases (JAK1 and TYK2) and signalling molecules (signal transducer and activator of transcription-1 [STAT1], STAT3, interferon-responsive-factor-1 [IRF-1] and IRF-2) as well as inhibitors of cytokine signalling (protein inhibitor of activated STAT1 [PIAS1] and suppressor of cytokine signalling 2 [SOCS2]) in biopsies of anal condylomas, LSILs as well as HSILs from HIV-positive individuals by a semi-quantitative reverse transcribed polymerase chain reaction (RT-PCR) method. We found that HSIL significantly differs in expression of these genes from LSIL and condylomas. Expression profile of HSIL samples showed activation of STAT3 signalling, probably accounting for the observed high levels of genes that support cellular proliferation (IRF-2, c-fos and c-myc). Decreases in levels of suppressors (IFN-gamma and IRF-1) and JAK1 kinase, but increases in levels of inhibitors of cytokine signalling (PIAS1 and SOCS2) might also contribute to the altered cytokine signalling in HSIL biopsies. These findings might reveal important molecular events associated with progression of LSIL to HSIL in HIV-infected men.
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PMID:The endogenous interferon system in anal squamous epithelial lesions with different grades from HIV-positive individuals. 1131 73

Kaposi's sarcoma and cervical cancer are the most common AIDS-related cancers. Anal cancer, affecting both men and women, has largely been ignored. Since many diseases can occur around the anal area, there are not definitive symptoms to diagnose any abnormal growths. Studies have shown that people living with HIV suffer anal cancer more often than non-infected people and it is more common among gay men and bisexuals. Some forms of human papillomavirus (HPV) are associated with the development of anal cancer. Treatment depends on the severity or the stage of the disease, the strength of the immune system, and the presence of other diseases. Treatments include surgery, chemotherapy and radiotherapy.
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PMID:[Anal cancer]. 1136 94

Participants in the National AIDS Malignancy Conference grappled with the effect of highly active antiretroviral therapy (HAART) on cancer. HAART has sharply decreased rates of opportunistic infections in a number of studies, but its impact on AIDS is complicated. Kaposi's sarcoma (KS) rates have rapidly declined in the past few years, corresponding to the time that HAART has been the standard of care. However, the effects on non-Hodgkin's lymphoma are mixed. Researchers also report a higher risk of cervical cancer among HIV-positive women. Immune-suppressed populations experience higher rates of cancer than expected, but the correlation between HIV-induced immune suppression and AIDS malignancies is not likely to be worked out soon. Charts show how the rates of HIV-associated KS and primary CNS lymphoma have decreased recently, and show how HHV-8 seropositivity correlates to the number of sexual partners. Researchers are calling for the development of a diagnostic tool similar to Pap smears to identify early cases of anal cancer.
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PMID:Less cancer--or more--with HAART? Or, reflections on a late opus. 1136 31

A new study presented by Annekathryn Goodman of Massachusetts General Hospital indicates that HIV positive women should receive annual colposcopies, along with Pap smears, to detect abnormal cell growth early. The recommendation is due to the fact that HIV positive women are more likely to have false-negative Pap smears than HIV negative women. In a related development, the FDA approved a new DNA-based blood test to detect human papillomavirus, which is associated with cervical and anal cancer. In addition, the National Cancer Institute (NCI) notified physicians that it has changed its recommendation for cervical cancer treatment. NCI now recommends both chemotherapy and radiation therapy for women with metastasized cervical cancer.
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PMID:Annual colposcopies and pap smears recommended for women with HIV. 1136

Kaposi's Sarcoma (KS) is a type of cancer thought to be caused by the human herpesvirus-8 (HHV-8). KS causes cancerous lesions on or beneath the skin. The disease may overpower the immune system and, in some cases, cause death. Studies show that the transmission of HHV-8 is linked to sexual contact, either genital or oral, and that people cannot contract KS without first having HHV-8. The recent decrease in the number of KS cases has been attributed to the use of highly active antiretroviral therapy (HAART). However, the incidence of anal cancer among gay men with HIV is increasing. HAART may be prompting this trend by prolonging lives, and giving more time for the disease to develop. The progression of anal cancer is noted, along with information about available screening tests. Surgical and non-surgical treatments are listed. All men who engage in sex with men are urged to be screened for this type of cancer.
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PMID:The trouble with tumors. 1136 67

The effect of highly active antiretroviral therapy (HAART) on the natural history of anal squamous intraepithelial lesions (ASIL)-the likely anal cancer precursor-and anal human papillomavirus (HPV) infection is unknown. ASIL severity and level of anal HPV DNA were evaluated among HIV-positive men who have sex with men (MSM) for at least 6 months before initiation of HAART. The results were compared with those from a 6-month period after initiation of HAART. Anal swabs for cytology and HPV studies were obtained, followed by high-resolution anoscopy and biopsy. Among men whose most severe pre-HAART diagnosis was atypical squamous cells of undetermined significance or low-grade ASIL, 18% (confidence interval [CI], 6-31%, 7 of 38) progressed and 21% (CI, 8-34%, 8 of 38) regressed 6 months after starting HAART. Seventeen percent (CI, 0-38%, 2 of 12) of study subjects who began with a normal diagnosis developed ASIL. Only 4% (CI, 0-10%, 1 of 28) of study subjects with high-grade ASIL regressed to normal. There was no reduction in the proportion of study subjects who tested positive for HPV DNA or HPV DNA levels after HAART initiation. The ASIL and HPV data were similar to those of the pre-HAART comparison period. These results indicate that HAART has little effect on either ASIL or HPV in the first 6 months after HAART initiation.
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PMID:Effect of highly active antiretroviral therapy on the natural history of anal squamous intraepithelial lesions and anal human papillomavirus infection. 1174 29

As the AIDS epidemic progresses, more and more HIV-infected patients will develop malignancies. The natural history of a malignancy may change dramatically in the presence of HIV infection. Among the AIDS and non-AIDS malignancies, the most frequently reported solid tumors are cervical and anal cancer, testicular germ cell tumors, lung cancer, and skin cancer. Regardless of epidemiology and outcome, the natural history of the majority of non-AIDS-defining tumors changes in the setting of HIV infection. Physicians who treat patients with AIDS and non-AIDS-related cancers need to become familiar with antiretroviral agents, drug-drug interactions, and the prophylaxis and management of opportunistic infections.
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PMID:AIDS and non-AIDS-related malignancies: a new vexing challenge in HIV-positive patients. Part II. Cervical and anal squamous epithelial lesions, lung cancer, testicular germ cell cancers, and skin cancers. 1206 17

The incidence of malignancies has increased in conjunction with epidemic of human immunodeficiency virus (HIV) disease and they are currently considered acquired immunodeficiency syndrome (AIDS)-defining conditions. Approximately 40% of all patients with AIDS have developed cancer during the course of HIV infections. Further, as survival has improved in HIV disease, the incidence of these malignancies has increased. The main malignancies noted are Kaposi's sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, rectal and anal cancer.
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PMID:[Neoplastic manifestations of HIV infection]. 1270 85

Risk factors for anal cancer include anal intercourse and infection with multiple strains of human papillomavirus, the causative agent of anal precancerous dysplasia. Several recent studies have shown that HIV-seropositive gay men are at greater risk for anal dysplastic lesions than seronegative gay men. Moreover, the risk for detection and progression of dysplastic lesions grows as the CD4+ cell count declines. A surgeon with a practice that includes gay men referred for anorectal disease presents data regarding the high prevalence of anal dysplasia in his patients.
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PMID:Anal dysplasia in men who have sex with men. 1272 7


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