Title:Human Immunodeficiency Virus-Associated Malignancies: A Therapeutic Update
Volume: 10
Issue: 2
Author(s): Antonello Malfitano, Giuseppe Barbaro, Alessandro Perretti and Giorgio Barbarini
Affiliation:
Keywords:
Human immunodeficiency virus, malignancies, chemotherapy, highly active antiretroviral therapy, biotherapy,
stem cell rescue
Abstract:
Implementation of highly active antiretroviral therapy (HAART) has deeply changed the landscape of HIVassociated
malignancies. Some AIDS-defining tumors, namely Primitive Lymphoma of Central Nervous System, have
drastically declined, whereas a steady increase has been observed for non-AIDS-defining tumors, maybe due to longer
survival of HIV-infected people. Easier immune restoration, subsequent to availability of a number of drugs targeting HIV
at different points, has decreased opportunistic infections which hampered treatment of HIV-associated cancers. As a
matter of fact these patients have been assimilated more and more with their negative counterpart, undergoing the same
aggressive approach. Consistently, procedures that have been so far precluded to HIV+ subjects, such as transplant of
hemopoietic stem cells, either autologous or allogenic, and liver transplant are expected to be performed more and more
extensively in this population. Which also would mean a full removal of the stigma which has weighed on it.
Hence, it is true-like that malignancies and related problems may in the next future make up a main concern for the HIV
specialist. Old and new challenges might be the drug-drug interaction of antiretrovirals or biotherapy-related infections or
the debated question of an earlier HAART implementation in the course of HIV disease, with CD4+ cells >500/μl. In fact,
if assimilation of HIV patients with cancer and the general population is a remarkable achieved goal, uniqueness of HIV
infection in terms of immune status still makes HIV-associated cancer a unique chapter in the setting of Oncology.
