Non-AIDS definings malignancies among human immunodeficiency virus-positive subjects: Epidemiology and outcome after two decades of HAART era

作     者：Pierluigi Brugnaro Erika Morelli Francesca Cattelan Andrea Petrucci Sandro Panese Franklyn Eseme Francesca Cavinato Andrea Barelli Enzo Raise 

作者机构：Infectious Diseases DepartmentCivil Hospital "SS.Giovanni e Paolo" 

出 版 物：《World Journal of Virology》 (世界病毒学杂志)

年 卷 期：2015年第4卷第3期

页      面：209-218页

学科分类：10[医学] 

主　　题：human immunodeficiency virus infection Malignancy Highly active antiretroviral therapy Nonacquired immunodeficiency syndrome-defining cancers 

摘      要：Highly active antiretroviral therapy(HAART) for humanimmunodeficiency virus(HIV) infection has been widely available in industrialized countries since 1996; its widespread use determined a dramatic decline in acquired immunodeficiency syndrome(AIDS)-related mortality, and consequently, a significant decrease of AIDS-defining cancers. However the increased mean age of HIV-infected patients, prolonged exposure to environmental and lifestyle cancer risk factors, and coinfection with oncogenic viruses contributed to the emergence of other malignancies that are considered non-AIDS-defining cancers(NADCs) as a relevant fraction of morbidity and mortality among HIV-infected people twenty years after HAART introduction. The role of immunosuppression in the pathogenesis of NADCs is not well defined, and future researches should investigate the etiology of NADCs. In the last years there is a growing evidence that intensive chemotherapy regimens and radiotherapy could be safely administrated to HIV-positive patients while continuing HAART. This requires a multidisciplinary approach and a close cooperation of oncologists and HIV-physicians in order to best manage compliance of patients to treatment and to face drug-related side effects. Here we review the main epidemiological features, risk factors and clinical behavior of the more common NADCs, such as lung cancer, hepatocellular carcinoma, colorectal cancer and anal cancer, Hodgkin s lymphoma and some cutaneous malignancies, focusing also on the current therapeutic approaches and preventive screening strategies.