Neoplasms in People Living with Human Immunodeficiency Virus

Abstract

People living with human immunodeficiency viruses (PLWH) are at increased risk for developing malignancies, particularly virally mediated cancers such as Kaposi sarcoma (KS), some types of lymphoma, and HPV‐related cancers, such as cervical cancer and anal cancer. PLWH also have higher rates of alcohol and tobacco use, which increases their risk of non‐virally mediated cancers, such as lung cancer and both oropharyngeal and non‐oropharyngeal head and neck cancers. KS and lymphomas tend to occur at lower CD4 counts, and the incidences of these cancers have decreased since the advent of effective combination antiretroviral therapy (ART). However, the incidence for virally mediated cancers (such as anal cancer) other non‐virally‐mediated non‐acquired immunodeficiency syndrome‐defining cancers (such as lung cancer) have risen in the past decade in part because PLWH are living longer with wide‐spread access to ART. In the past, PLWH with cancers often had lower survival and poorer outcomes due to severe immunodeficiency and poor performance status. In the modern ART era, survival and outcomes for individuals with human immunodeficiency virus (HIV)‐associated lymphomas are generally similar to the HIV‐negative population using standard rituximab‐based multi‐agent chemotherapy. For PLWH with other solid tumors, standard of care treatment is also currently recommended. Active areas of research for cancers in PLWH includes cancer prevention, immunotherapy, and continued development of new therapeutics to improve outcomes.