People with HIV are at higher risk of developing cancer and with more than 6m people living with HIV in the country, South Africa faces the threat of an HIV-related cancer epidemic, reports Health-e. SA and Africa can expect an increase in certain HIV-related cancers, said George Washington University Prof Sylvia Silver during a recent Cape Town talk.
SA’s high HIV prevalence is already reflected in its cancer statistics. In 2000, the country had 849 cases of Kaposi sarcoma, a type of cancer in which tumours can emerge under the skin, and other areas of the body such as the mouth, nose and organs. By 2007, Kaposi sarcoma cases had increased by almost 200%.
People living with HIV are several thousand times more likely than uninfected people to be diagnosed with Kaposi sarcoma and at least 70 times more likely to be diagnosed with the cancer, non-Hodgkins lymphoma, which affects the body’s immune system.
Both cancers, as well as the cervical cancer, are considered ‘Aids-defining cancers,’ meaning their diagnosis in HIV-positive people means that their HIV infection has progressed to AIDS.
Emerging research is also showing that other cancers, like anal, liver and lung cancers are also more likely to develop in people living with HIV.
Kaposi sarcoma, cervical and lung cancer, as well as non-Hodgkin lymphoma are among the 10 most common cancers in SA.
Several risk factors place HIV-positive people at a higher risk of cancer, according to Prof Johann Schneider, head of Stellenbosch University’s Division of Anatomical Pathology.‘With antiretroviral treatment, HIV-positive patients are living longer and getting older, and many cancers are associated with old age,’ says Schneider whose unit hopes to facilitate more research into the intersection between HIV and cancer. ‘Many cancers are also related to certain viral infections.’
Cancer often also presents differently in people with HIV, according to Schneider. ‘Some of the non-Aids defining cancers such as anal, colorectal, breast and lung cancer occur at an earlier age (in people living with HIV) than in non-infected people, and are usually more advanced at diagnosis,’ he added. ‘HIV-positive patients with lung, prostate and Hodgkin lymphoma also have much poorer outcomes.’
Although antiretroviral therapy reduces the incidence of Kaposi sarcoma and non-Hodgkin lymphoma, incidence of these two cancers are still higher among HIV-positive individuals on ART than non-infected people.
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