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Study Links Improved HIV Treatment to Reduced Cancer Risk

Since the introduction of highly active antiretroviral therapy (HAART) in 1996, there has been an overall 42% decline in the risk of secondary cancers in individuals who previously have been diagnosed with Kaposi sarcoma (KS).

That’s the takeaway of a study, published last month in the Journal of the American Medical Association, whose findings suggest that effective HIV treatment does more than just reduce viral load. By strengthening the immune system, HAART helps the body eliminate cells that could grow into cancer.

Fahad Mukhtar, the lead author of the study and cancer researcher at the University of South Florida, reviewed 14,905 cases of KS from nine cancer registries. He found that people who had been diagnosed with KS between 1980 – 1995 were significantly more likely to later develop cancers of the blood, lymph, and liver. Following the advent of HAART, the risk of these secondary cancers dropped precipitously in individuals who had been diagnosed with KS between 1996 – 2013.

Cases of secondary cancer usually appear several years after the diagnosis of KS. Although the overall risk of secondary cancers is down, some individual types of cancer have become more common since the availability of effective HIV treatment. In addition to rises in acute lymphocytic leukemia, rates of cancer of the tongue and penis are up, too. Monitoring for the development of these cancers, as the results indicate, is especially important in people who have been diagnosed with KS in the past.

Previous research has found that constant activation of the immune system, as found in persons infected with HIV, is critical to tumor progression. Cancer prevention, therefore, is particularly important among HIV-positive people and could be addressed through educational strategies.

“I think public health programs should educate the people who are at risk and also help disseminate the information to clinicians as well,” said Mukhtar. “Even the media could help disseminate such findings to the public as most people do not have access or time to read published papers or they may not understand the findings.”

Mukhtar noted that the co-occurrence of KS with other cancers in people with HIV/AIDS also suggests a possible common set of causes shared between KS and tumors that are associated with KS. Understanding the commonalities underlying these types of cancer could help physicians better predict what type of cancer would most likely form after KS. “It will be interesting to study this further,” Mukhtar added.

One of the greatest successes of new antiretroviral medications is helping people with HIV live longer than ever before. As life expectancy continues to increase, however, so does the risk of developing cancer. Regardless of HIV status, patients are generally advised that certain lifestyle changes, like diet, exercise, and smoking cessation, can help reduce inflammation and delay cancer. Until we fully understanding the mechanisms underlying progression to cancer in HIV-positive people, making these changes – along with daily adherence to antiretroviral medication – may yield health benefits in other areas, too.