Epidemiology and clinical characteristics of non-AIDS-defining malignancies

Since the widespread introduction of HAART over 10 years ago, the epidemiology of HIV-related malignancies has been evolving. While the incidence and the mortality of AIDS-defining cancers (Kaposi sarcoma and non-Hodgkin lymphoma, in particular) have been decreasing, the incidence of and the mortality from non-AIDS-defining malignancies appear to be increasing. This chapter reviews the recent literature published on the epidemiology and clinical manifestations, including outcomes of non-AIDS-defining malignancies. Although HAART has improved survival from opportunistic infections and AIDS-defining malignancies; it appears that HIV-infected individuals on HAART still have an elevated incidence of certain non-AIDS malignancies (especially those that are mediated by viral oncogenesis, such as EBV and HPV). In addition, it is unclear if utilization of HAART during treatment results in equivalent survival compared to HIV-negative individuals. The focus of the chapter will be on the more common non-AIDS malignancies such as Hodgkin disease, SCCA, and lung cancer. However, the epidemiology of other non-AIDS-defining malignancies will also be discussed including skin cancer, head and neck cancer, conjunctival cancer, testicular cancer, leiomyosarcoma, hepatocellular carcinoma, breast cancer, multiple myeloma, leukemia, colon cancer, and prostate cancer.