Clinical characteristics of non-AIDS defining malignancies among people living with HIV

Abstract

The human immunodeficiency virus (HIV) is a retrovirus that attacks immune system and makes individuals more vulnerable to infectious or malignant diseases. This condition is known as AIDS (acquired immunodeficiency syndrome), which was once considered an incurable disease. However, owing to the advances in treatment, it is now possible for people to live without progressing to AIDS. On the other hand, non-AIDS-defining malignancies (NADM) have become a leading cause of death among people living with HIV (PLWH) today.

Previous studies have showed that PLWH have a poorer prognosis for malignant diseases than in those without HIV infection (non-PLWH), despite the well-controlled HIV infection. The reasons of the poor prognosis of PLWH remain unclear. Although current international guidelines emphasize the importance of offering PLWH diagnosed with malignant diseases the same treatment as the general population, they are often excluded from major clinical trials and research studies. Little is known about the clinical characteristics of malignant diseases among PLWH in Japan, leading to the loss of opportunity to receive the same treatment as non-PLWH.

To ensure that PLWH have access to the latest cancer treatment, it is important to determine the impact of HIV infection on cancer treatment. This study aims to investigate NADM in PLWH by focusing on:

Comparing the clinicopathological characteristics of NADM between PLWH and non-PLWH
Assessing and comparing the efficacy and safety of treatment
Identifying prognostic factors of NADM

Perspectives

This study will provide new evidence on the treatment toxicities and current issues of NADM in PLWH, which will be useful to both HIV healthcare providers and oncology healthcare providers. The result of the study may lead to encourage proposing clinical studies including PLWH as an eligible population.

Comments from principal researcher

Kenju Ando, resident, Department of Breast and Medical Oncology, National Center for Global Health and Medicine

Clinical research and developing treatment for NADM in PLWH has not progressed due to its rarity of PLWH. However, the number of patients with HIV and NADM is expected to increase as the treatment for HIV has developed. We hope to challenge this unmet medical need thorough this joint research with the National Cancer Center Hospital.

Shared Researchers

Toshiharu Hirose, Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital