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If you can diagnose and treat KS can you diagnose and treat HIV+ cancers? Growing evidence of linkages.Treating Human Immunodeficiency Virus–Related Lymphoma"...Complexity of Medicine
It seems like every time you make a breakthrough in treating the disease, it reveals deeper complexities.... ....HIV is clearly an indirect cause of cancer, simply by causing severe
depression of the immune system, and the cancers that arise in that
setting are commonly caused by opportunistic organisms taking advantage
of the host’s weakened resistance. But recently, biologic mechanisms
have been described indicating that HIV itself may directly cause the
lymphomas as well, which is very intriguing..... ... HIV-Related Cancers What cancers are HIV-positive individuals at risk for? Combination antiretroviral therapy has significantly reduced the risk of AIDS-defining cancers—Kaposi’s sarcoma, high-grade B-cell lymphoma, and cervical cancer—but this risk still remains elevated compared to the population as a whole. Even with an undetectable viral load, or with CD4 cell counts above 500 cells/dL, the risk of lymphoma is nearly threefold that expected in the general population, for example. However, HIV-infected individuals are also at risk for additional cancers that were not originally thought to be connected to this epidemic. They are primarily cancers related to organisms. Human papillomavirus, for example, causes anal and oropharyngeal cancers in addition to cervical cancer, and HIV-positive patients are at increased risk for all of them. Hodgkin lymphoma, which is caused by Epstein-Barr virus in this setting, is also clearly increased in HIV-infected people. And if you are HIV-infected and also infected by hepatitis C or B, there’s a greater risk of liver cancer than without the underlying HIV. None of these cancers were originally thought to be related to HIV or immunosuppression, but we’re now seeing statistical increases in these tumors among HIV-infected patients. Although combination antiretroviral agents are remarkably effective, even if someone’s CD4 cells become elevated beyond 500 cells/dL and their viral load becomes undetectable, they still have immune defects that have not been corrected by those drugs and are still at risk for some of these organism-caused cancers. They are also at increased risk of tobacco-associated lung cancer...." http://www.ascopost.com/issues/april-25-2017/treating-human-immunodeficiency-virus-related-lymphoma/ Concurrent treatment of HIV and cancer improves survival outcomes... “One-third of deaths among people with HIV in the United States are
cancer-related,” Torres said. “That may have to do with the late
diagnosis of HIV in patients whose cancer is diagnosed first and the
limited approach to HIV screening at U.S. cancer centers.”
Screening cancer patients for HIV Because many patients with both HIV and cancer are unaware that they have HIV, Torres and Granwehr believe that HIV screening should be included in the routine workup for cancer patients. Torres said, “Of the HIV-positive patients who come to MD Anderson for cancer care, 16%–33% don’t know they have HIV until they get tested here.”... |
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