Abstract
Adults living with HIV have an increased risk of malignancy yet there is little data for adolescents and young adults. We reviewed recently published cancer epidemiology, treatment, and outcome data for adolescents and young adults living with HIV (AYALHIV) aged 10 to less than 25 years between 2016 and 2017. AYALHIV are at increased risk of developing cancer compared to their uninfected peers. Kaposi sarcoma and non-Hodgkin lymphoma occur most frequently with variation by geographical region. Increased cancer risk is associated with HIV-related immunosuppression and coinfection with oncogenic viruses. Published data, particularly on posttreatment outcomes, remain limited and analyses are hampered by lack of data disaggregation by age and route of HIV transmission. Although data are sparse, the increased cancer risk for AYALHIV is the cause for concern and must be modified by improving global access and uptake of antiretroviral therapy, human papilloma virus (HPV) and hepatitis B virus (HBV) vaccination, screening for hepatitis B and C infection, and optimized cancer screening programs. Education aimed at reducing traditional modifiable cancer risk factors should be embedded within multidisciplinary services for AYALHIV.
Overview
- The study reviewed recent data on cancer epidemiology, treatment, and outcomes for adolescents and young adults living with HIV (AYALHIV) between 2016 and 2017.
- The study found that AYALHIV have an increased risk of developing cancer compared to their uninfected peers, with Kaposi sarcoma and non-Hodgkin lymphoma occurring most frequently.
- The study aims to raise awareness of the increased cancer risk for AYALHIV and highlight the need for improved access to antiretroviral therapy, vaccinations, and screening programs.
Comparative Analysis & Findings
- AYALHIV have an increased risk of developing cancer compared to their uninfected peers, with a higher risk of Kaposi sarcoma and non-Hodgkin lymphoma.
- Increased cancer risk is associated with HIV-related immunosuppression and coinfection with oncogenic viruses.
- Limited published data exist on posttreatment outcomes, and analyses are hampered by lack of data disaggregation by age and route of HIV transmission.
Implications and Future Directions
- Improved global access and uptake of antiretroviral therapy, human papilloma virus (HPV) and hepatitis B virus (HBV) vaccination, and screening for hepatitis B and C infection are essential.
- Optimized cancer screening programs and education aimed at reducing traditional modifiable cancer risk factors should be embedded within multidisciplinary services for AYALHIV.
- Future research should focus on collecting more robust data on cancer incidence, treatment outcomes, and mortality for AYALHIV, as well as investigating ways to reduce cancer risk and improve outcomes.