Starting HIV Treatment Early Reduces HIV-Related Cancer Risk by 74%

Starting HIV treatment soon after diagnosis may reduce the risk of developing HIV-related cancer by 74%, according to a recent study. However, starting treatment does not seem to lower the risk of developing cancer unrelated to HIV, the study finds. The data remained unclear on whether having an undetectable viral load helped reduce the risk of HIV-related cancers.

Researchers for the study, which was published Clinical Infectious Diseases, looked at data from the landmark START study, which was stopped early in 2015 because it found overwhelming evidence for the benefits of starting HIV treatment immediately versus waiting until CD4 counts drop.

For this analysis, the researchers compared two groups within the START study, one group that had started treatment immediately and a second group that had delayed. Over 4,600 individuals were followed over an average of three years.

Fourteen cancer malignancies developed in the immediate-treatment group (six HIV-related and eight HIV-unrelated), while 39 cancer malignancies developed in the delayed group (23 HIV-related and 16 HIV-unrelated).

This translated into 74% fewer cases of HIV-related cancer for those who started treatment immediately. There were also 51% fewer cases of HIV-unrelated cancer for the immediate-treatment group, but this finding was not statistically significant, meaning it could have been purely due to chance.

The lower HIV-related cancer risk "was driven by decreased rates of Kaposi's sarcoma and non-Hodgkin lymphoma -- cancers thought to be caused by infections of Epstein Barr virus and human herpes virus-8 -- implying that immune injury caused by HIV is a factor in cancer development, even in individuals with normal-range CD4 counts," Benjamin Young, M.D., Ph.D., told

"The study conclusions strongly reinforce the urgency to initiate antiretroviral therapy in people living with HIV, irrespective of their CD4 count or symptoms -- consistent with current World Health Organization treatment guidelines and national guidelines in an increasing number of countries (including the U.S., France, Spain, Brazil and Mexico)," Young added.