HIV-associated malignancies in sub-Saharan Africa: progress, challenges, opportunities
Published Date:Jan 2017
Source:Curr Opin HIV AIDS. 12(1):89-95.
Pubmed Central ID:PMC5241291
Funding:K01 TW009488/TW/FIC NIH HHS/United States
U54 CA190152/CA/NCI NIH HHS/United States
R25 TW009340/TW/FIC NIH HHS/United States
P20 CA210285/CA/NCI NIH HHS/United States
P30 CA016086/CA/NCI NIH HHS/United States
U2G PS001965/PS/NCHHSTP CDC HHS/United States
U01 CA121947/CA/NCI NIH HHS/United States
R21 CA180815/CA/NCI NIH HHS/United States
Description:Purpose of review
Summarize recent developments for HIV-associated malignancies (HIVAM) in low- and middle-income countries (LMIC) with particular focus on sub-Saharan Africa (SSA).
Antiretroviral therapy (ART) scale-up is leading to epidemiologic transitions in LMIC similar to high-income countries, with aging and growth of HIV-infected populations, declining infectious deaths, increasing cancer deaths, and transitions from AIDS-defining cancers (ADC) to non-AIDS defining cancers (NADC). Despite ART scale-up, HIVAM burden remains high including enormous ADC burden in SSA. For Kaposi sarcoma (KS), patients treated with ART and chemotherapy can experience good outcomes even in rural SSA, but KS heterogeneity remains insufficiently understood including virologic, immunologic, and inflammatory features which may be unique to LMIC. For cervical cancer, scale-up of prevention efforts including vaccination and screening is underway, with benefits already apparent despite continuing high disease burden. For non-Hodgkin lymphoma (NHL), curative treatment is possible in the ART era even in SSA, and multifaceted approaches can improve outcomes further. For many other prevalent HIVAM, care and research efforts are being established to guide treatment and prevention specifically in LMIC.
Sustained investment for HIVAM in LMIC can help catalyze a cancer care and research agenda which benefits HIV-positive and HIV-negative patients worldwide.
Supporting Files:No Additional Files
You May Also Like: