Risk of cancer for us HIV+ people
Dec 8, 2012
Hi Nelson, After reading all I could find on the Internet it is still not clear to me if in fact meds have reduced the risk of certain cancers or not. I know it reduced the chance of getting KS but what about lymphoma? I read somewhere that lymphoma is responsible for 30% of deaths among HIV + people and that 10% of us will eventually get it. As a young person in my mid twenties and already taking 10 years of meds I find this very disturbing!Do you have more recent information about this, or how to avoid it? I also read that a low nadir is a risk factor, and I wonder why would a low cd4 count registered 10-11 years ago would influence my chance of getting cancer if since then with the help of meds my cd4 was above 500 every year, and undetectable? Thank you.
Response from Mr. Vergel
You have great questions. I know that reading cancer related reports in HIV can worry many patients like you.
Liver cancer (mostly in patients coinfected with Hepatitis B and C who are not successfully treated), lung cancer (mostly people who smoke), lymphoma and anal cancer are the most common cancers in HIV. Cancers in HIV
Nadir (the lowest recorded) CD4 cell counts have been correlated to anal cancer risk. It seems that even after our CD4 cells go up, there is a part of the immune system that never fully returns to normal when we start at low CD4 cells (under 200 cells/ml). Incidence of HIV-Related Anal Cancer Remains Increased Despite Long-Term Combined Antiretroviral Treatment: Results From the French Hospital Database on HIV.
By the way, there are cure studies looking for people who have HIV and lymphoma. These patients represent a population whose risk-to-benefit ratio justifies conditioning and stem cell transplants to see if we can replicate what happened to Timothy Brown, the cured HIV patient.
The best guidelines for anal cancer in HIV come from the NY State Dept of Health. This is probably the most concerning cancer since most of us do not have access to screening for anal dysplasia and medical groups cannot agree on what the best treatments are.
Keep in mind that most of the incidence data we have about cancers in HIV come from long term, older survivors who were exposed to older medications. We do not know and cannot assume that younger patients who have started treatment in the past 5 years will have the same incidence of cancers as those reported in studies. And many of long term survivors like myself have never had any cancer, even with viremia for a long time.
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