People living with HIV remain at risk of AIDS-defining cancers in the era of effective antiretroviral therapy, and also have higher rates of several non-AIDS cancers than the general population, including lung, anal and liver cancer, according to findings from a study of more than 86,000 HIV-positive people published in the October 6 Annals of Internal Medicine.

Since the advent of effective combination antiretroviral therapy (ART) in the mid-1990s, rates of the three AIDS-defining cancers – Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer – have fallen among people with HIV. These cancers are caused by opportunistic viruses that can take hold when the immune system is damaged and CD4 T-cell counts are low, though human papillomavirus (HPV) also causes cervical and anal cancer in otherwise healthy people.

Most studies, however, have found that HIV-positive people have a higher overall risk for other non-AIDS-related cancers compared to HIV-negative populations, although data have been inconsistent about specific cancer types. In fact, cancer rates among people with HIV have risen over time as they live long enough to develop malignancies.

Michael Silverberg of Kaiser Permanente Northern California and fellow investigators evaluated trends in cumulative incidence of common cancer types by HIV status among participants in the large North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

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