Do people infected with human immunodeficiency virus (HIV) have an increased risk of cancer?
Yes. People infected with HIV have a substantially higher risk of some types of cancer compared with uninfected people of the same age.1 The general term for these cancers is “HIV-associated cancers.” Three of these cancers are known as “acquired immunodeficiency syndrome (AIDs)-defining cancers” or “AIDS-defining malignancies”: Kaposi sarcoma, aggressive B-cell non-Hodgkin lymphoma, and cervical cancer. A diagnosis of any of these cancers in someone infected with HIV confirms a diagnosis of AIDS.
Compared with the general population, people infected with HIV are currently about 500 times more likely to be diagnosed with Kaposi sarcoma, 12 times more likely to be diagnosed with non-Hodgkin lymphoma, and, among women, 3 times more likely to be diagnosed with cervical cancer.2
In addition, people infected with HIV are at higher risk of several other types of cancer (collectively called “non–AIDS-defining cancers”).1,2 These other malignancies include cancers of the anus, liver, oral cavity/pharynx, and lung, and Hodgkin lymphoma.3,4
People infected with HIV are 19 times more likely to be diagnosed with anal cancer, 3 times as likely to be diagnosed with liver cancer, 2 times as likely to be diagnosed with lung cancer, about 2 times as likely to be diagnosed with oral cavity/pharynx cancer, and about 8 times more likely to be diagnosed with Hodgkin lymphoma compared with the general population.2
In addition to being linked to an increased risk of cancer, HIV infection is associated with an increased risk of dying from cancer. HIV-infected people with a range of cancer types are more likely to die of their cancer than HIV-uninfected people with these cancers.5,6
Why might people infected with HIV have a higher risk of some types of cancer?
Infection with HIV weakens the immune system and reduces the body’s ability to fight viral infections that may lead to cancer.2,7,8 The viruses that are most likely to cause cancer in people with HIV are9:
- Kaposi sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), which causes Kaposi sarcoma and some subtypes of lymphoma
- Epstein-Barr virus (EBV), which causes some subtypes of non-Hodgkin and Hodgkin lymphoma
- Human papillomaviruses (HPV), high-risk types of which cause cervical cancer, most anal cancers, and oropharyngeal, penile, vaginal, and vulvar cancer
- Hepatitis B virus (HBV) and hepatitis C virus (HCV), which both cause liver cancer
HIV-infected persons are more likely to be infected with these viruses than people in the general population.10–13
In addition, the prevalence of some traditional risk factors for cancer, especially smoking (a known cause of lung and other cancers) and heavy alcohol use (which can increase the risk of liver cancer), is higher among people infected with HIV.12,14 Also, because people infected with HIV have compromised immune systems, both immunosuppression and inflammation may have direct or indirect roles in the development of some cancers that are elevated in people infected with HIV.2,9
The poorer cancer survival of HIV-infected people may result, at least in part, from the weakened immune system in such individuals. The increased risk of death could also result from the cancer being more advanced at diagnosis, delays in cancer treatment, or poorer access to appropriate cancer treatment.
READ FULL ARTICLE From National Cancer Institute