AIDS and associated malignancies

Malignancies are a major complication of AIDS. The most frequently diagnosed HIV-associated cancer is Kaposi's sarcoma (KS) followed by AIDS-related non-Hodgkin lymphoma (ARL). The development of highly active antiretroviral therapy (HAART) has resulted in a marked decrease in the number of cases of KS and to a lesser degree ARL in countries where these drugs are widely available; however, these tumors are increasing in incidence in developing nations and still pose a major threat in severely immunocompromised patients. AIDS-related KS and ARL are distinct from their counterparts seen in HIV-1 seronegative patients. About half of all cases of ARLS are associated with a gamma herpesvirus, Epstein-Barr virus (EBV) or human herpesvirus-8 (HHV-8) and AIDS-related KS is far more aggressive than the classical variety of the disease. Several other types of tumors occur with increased frequency in AIDS patients including leiomyosarcoma in children, squamous cell carcinoma of the conjunctiva and multi-centric Castleman's disease. It is likely that as the epidemic expands and AIDS becomes more of a chronic condition the spectrum of HIV-associated cancer will also evolve.