Association of Cancer With AIDS-Related Immunosuppression in Adults

Abstract

Immunosuppression associated with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) markedly increases the risk of Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL).¹ These malignancies and invasive cervical cancer are the only AIDS-defining cancers in HIV-infected individuals.² Other specific cancers also occur in excess, but the risk pattern depends on the geographic region and the HIV exposure group studied.^3,4 In industrialized parts of the world, a high level of risk has been found for anal cancer⁵ and Hodgkin disease,^6-8 and marginally significant increases were reported for seminoma, multiple myeloma, and brain cancer.^7,8 We used data from the recently updated AIDS-Cancer Match Registry Study to investigate the cancer pattern in the years surrounding the time of AIDS diagnosis among 302 834 adult persons with HIV/AIDS (PWAs) in the United States. Specifically, we aimed at identifying cancers that are likely to be influenced by immunosuppression, distinguishing them from those occurring in excess among PWAs due to lifestyle-related exposures linked to cancer risk independently of immunosuppression.