Immunosuppression Increases Risk of HPV-related Cancers in AIDS Patients
The risk of HPV-related cancers is elevated among AIDS patients. This risk continues to increase as patients’ immune systems become more compromised, according to the results of a study published in the Journal of the National Cancer Institute.
Human papillomaviruses (HPV) consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer.
Individuals with AIDS (or Acquired Immune Deficiency Syndrome) suffer from a compromised immune system. Researchers have long known that these individuals are at a higher risk of developing HPV, and subsequently HPV- related cancers; however, the extent to which immunosuppression plays a role in the higher risk of HPV-related cancers has been unclear.
Researchers from the National Cancer Institute evaluated data from 499,230 patients diagnosed with AIDS between 1980 and 2004 and linked this data with cancer registries in 15 U.S. regions. They found a statistically significant elevated risk of all HPV-related cancers among AIDS patients. These include cancers of the anus, cervix, oropharynx, penis, vagina, and vulva. Furthermore, the researchers assessed the CD4 T-cell count in order to determine if there was a relationship between immunosuppression and incidence of HPV-related cancers. They then compared incidence rates among three time periods: 1980-1989, 1990-1995, and 1996-2004.
Highly active antiretroviral therapy (HAART) was introduced in 1996; HAART has been known to prolong survival among AIDS patients. Between 1996 and 2004, a low CD4 T-cell count was associated with an increased risk of anal cancer among men with AIDS. This could indicate that prolonged survival (due to use of HAART) may be associated with an increased risk of certain HPV-related cancers.
The researchers concluded that the risk of certain HPV-related cancers among AIDS patients was elevated and continued to increase as immunosuppression increased. They suggest that because HIV- and AIDS-infected patients will likely not benefit from HPV vaccines, it is important to step up screening for cervical and anal cancer among this population.
 Chaturvedi AK, Madeleine MM, Biggar RJ, et al. Risk of human papillomavirus-associated cancers among persons with AIDS. Journal of the National Cancer Institute. 2009; 101:1120-1130.
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