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AIDS patients face new risk of common cancers
Issue date: 3/13/08
AIDS is a complicated clinical syndrome that involves an increased risk of a wide range of disorders, from infections to cancers to dementia. As physicians have come to appreciate the diseases AIDS patients are likely to develop, the rates of these additional disorders have decreased.
A new study from the Hopkins Department of Medicine shows an unexpected finding in rates of cancer in AIDS patients. There are a handful of cancers, called AIDS-defining cancers, or ADCs, that are generally seen at much greater rates in cancer patients.
ADCs include Kaposi sarcoma, non-Hodgkin's lymphoma and cervical cancer, all of which are caused by viral infections. Other cancers are considered non-AIDS-defining, or non-ADCs.
The Hopkins group studied patients receiving today's standard AIDS treatment, highly active antiretroviral therapy (HAART). Patients on HAART had a decreased rate of ADCs, as expected. Surprisingly, however, their rates of other cancers have increased.
The researchers performed a retrospective analysis of clinical records of 2,566 Hopkins Hospital AIDS patients from 1996 through 2005. Overall rates of ADCs decreased from 12.5 cases per 1,000 in 1996 to 3.5 cases per 1,000 in 2005 - an overall decrease of almost 75 percent.
At the same time, the rates of several non-ADCs increased dramatically. The annual incidence rate increased from 3.9 to 7.1 cases per 1,000 between 1996 and 2005, a trend that was confirmed to be statistically significant.
Some of the most common cancers, including liver and lung cancers, were five to 39 times more common in HIV-positive patients than in the general public.
Patients who were older were more likely to develop non-ADCs. Patients who were injection drug users or were infected with hepatitis-B or hepatitis-C virus were also more likely to develop non-ADCs. Age, race and sex were found not to be major risk factors.
The finding that non-ADC rates are increasing in AIDS patients is a considerable public health concern. It indicates that doctors need to screen AIDS patients more carefully for these cancers, and it could indicate a shift in the diseases associated with AIDS thanks to improved treatments for some conditions.
A new study from the Hopkins Department of Medicine shows an unexpected finding in rates of cancer in AIDS patients. There are a handful of cancers, called AIDS-defining cancers, or ADCs, that are generally seen at much greater rates in cancer patients.
ADCs include Kaposi sarcoma, non-Hodgkin's lymphoma and cervical cancer, all of which are caused by viral infections. Other cancers are considered non-AIDS-defining, or non-ADCs.
The Hopkins group studied patients receiving today's standard AIDS treatment, highly active antiretroviral therapy (HAART). Patients on HAART had a decreased rate of ADCs, as expected. Surprisingly, however, their rates of other cancers have increased.
The researchers performed a retrospective analysis of clinical records of 2,566 Hopkins Hospital AIDS patients from 1996 through 2005. Overall rates of ADCs decreased from 12.5 cases per 1,000 in 1996 to 3.5 cases per 1,000 in 2005 - an overall decrease of almost 75 percent.
At the same time, the rates of several non-ADCs increased dramatically. The annual incidence rate increased from 3.9 to 7.1 cases per 1,000 between 1996 and 2005, a trend that was confirmed to be statistically significant.
Some of the most common cancers, including liver and lung cancers, were five to 39 times more common in HIV-positive patients than in the general public.
Patients who were older were more likely to develop non-ADCs. Patients who were injection drug users or were infected with hepatitis-B or hepatitis-C virus were also more likely to develop non-ADCs. Age, race and sex were found not to be major risk factors.
The finding that non-ADC rates are increasing in AIDS patients is a considerable public health concern. It indicates that doctors need to screen AIDS patients more carefully for these cancers, and it could indicate a shift in the diseases associated with AIDS thanks to improved treatments for some conditions.
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