HIV and Malignancies

Background:

Cancer remains an under-recognized health condition throughout most of Africa, and improved surveillance systems for determining cancer incidence, mortality, and prevalence of risk factors are badly needed. HIV and infectious diseases remain prevalent in Africa, with as many as 36 percent of cancers in Africa being infection-related — twice the world average.

Kaposi's sarcoma (KS) is the most common type of cancer in HIV-1-infected individuals who are progressing to AIDS. In Uganda, KS accounts for four of every 10 cancer diagnoses made at the Uganda Cancer Institute and nine out of 10 of these patients are infected with HIV-1. Although highly active antiretroviral therapy (HAART) can promote KS-regression, nearly 50% of patients fail to achieve a total remission. Even with improved availability of antiretroviral therapy, KS remains a major clinical problem in sub-Saharan Africa.

Kaposi's sarcoma (KS) is the most common type of cancer in HIV-1-infected individuals who are progressing to AIDS. In Uganda, KS accounts for four of every 10 cancer diagnoses made at the Uganda Cancer Institute and nine out of 10 of these patients are infected with HIV-1. Although highly active antiretroviral therapy (HAART) can promote KS-regression, nearly 50% of patients fail to achieve a total remission. Even with improved availability of antiretroviral therapy, KS remains a major clinical problem in sub-Saharan Africa.

Among the most devastating neurologic complication of HIV is primary CNS lymphoma (PCNSL), an AIDS-defining illness usually associated with short survival. Establishing the diagnosis of AIDS-related PCNSL can be difficult for a number of reasons, including the fact that results of neuro-imaging including MRI and PET as well as EBV evaluations are non-specific and established cerebrospinal fluid (CSF) tests lack specificity and sensitivity. Moreover, standard interventions for AIDS-related PCNSL have not been improved upon in decades.

Among the most devastating neurologic complication of HIV is primary CNS lymphoma (PCNSL), an AIDS-defining illness usually associated with short survival. Establishing the diagnosis of AIDS-related PCNSL can be difficult for a number of reasons, including the fact that results of neuro-imaging including MRI and PET as well as EBV evaluations are non-specific and established cerebrospinal fluid (CSF) tests lack specificity and sensitivity. Moreover, standard interventions for AIDS-related PCNSL have not been improved upon in decades.

The HIV epidemic has increased cervical cancer morbidity and mortality, especially in developing countries. The increased biologic risk for cervical cancer associated with HIV-infection combined with the strain on already overburdened health care systems work synergistically to increase the disparity in cervical cancer risk for women in these countries. Prevention efforts that have reduced the incidence of cervical cancer to close to zero in resource-rich countries are costly and not available in most low-resource settings.

The HIV epidemic has increased cervical cancer morbidity and mortality, especially in developing countries. The increased biologic risk for cervical cancer associated with HIV-infection combined with the strain on already overburdened health care systems work synergistically to increase the disparity in cervical cancer risk for women in these countries. Prevention efforts that have reduced the incidence of cervical cancer to close to zero in resource-rich countries are costly and not available in most low-resource settings.

Background:

Cancer remains an under-recognized health condition throughout most of Africa, and improved surveillance systems for determining cancer incidence, mortality, and prevalence of risk factors are badly needed. HIV and infectious diseases remain prevalent in Africa, with as many as 36 percent of cancers in Africa being infection-related — twice the world average.