Overview
AIDS-related cancers are types of cancer that occur more frequently or more aggressively in people with Acquired Immunodeficiency Syndrome (AIDS). Due to a weakened immune system caused by HIV (Human Immunodeficiency Virus), individuals with AIDS are at higher risk for developing certain malignancies, particularly those linked to viral infections. The most common types include Kaposi sarcoma, non-Hodgkin lymphoma, and invasive cervical cancer.
What is AIDS-Related Cancer?
AIDS-related cancers refer to malignancies that are either caused or promoted by the compromised immune system in people living with HIV/AIDS. These cancers are often referred to as “AIDS-defining” cancers, meaning their presence can mark the progression from HIV to AIDS.
There are three main AIDS-related cancers:
- Kaposi Sarcoma (KS) – caused by Human Herpesvirus 8 (HHV-8)
- Non-Hodgkin Lymphoma (NHL) – especially primary central nervous system lymphoma
- Invasive Cervical Cancer (ICC) – caused by persistent infection with high-risk human papillomavirus (HPV)
Other non-AIDS-defining cancers like anal cancer, liver cancer, and Hodgkin lymphoma are also more common in HIV-positive individuals.
Symptoms
Symptoms vary based on the specific type of cancer, but may include:
- Kaposi Sarcoma: Purple, red, or brown skin lesions, often on the face, legs, or inside the mouth
- Non-Hodgkin Lymphoma: Swollen lymph nodes, fever, night sweats, weight loss
- Cervical Cancer: Abnormal vaginal bleeding, pelvic pain, pain during intercourse
- General symptoms: Fatigue, unexplained weight loss, chronic infections
Causes
AIDS-related cancers are primarily caused by a combination of HIV-induced immune suppression and co-infection with oncogenic viruses, such as:
- Human Herpesvirus 8 (HHV-8) – linked to Kaposi sarcoma
- Epstein-Barr Virus (EBV) – associated with certain lymphomas
- Human Papillomavirus (HPV) – linked to cervical and anal cancers
- Hepatitis B and C viruses – associated with liver cancer
The impaired immune system is unable to suppress these viruses, allowing cancerous growths to develop.
Risk Factors
- Advanced HIV infection/AIDS
- Low CD4 cell counts
- Lack of antiretroviral therapy (ART)
- Co-infection with cancer-associated viruses
- Smoking
- Male sex (higher risk for Kaposi sarcoma)
- Unprotected sex or multiple sexual partners (increased HPV risk)
Complications
- Cancer metastasis (spreading to other organs)
- Severe opportunistic infections
- Organ failure (e.g., liver or lung)
- Treatment resistance or poor response to chemotherapy
- Death if left untreated
Immunocompromised individuals often experience more aggressive and rapidly progressing cancers.
Prevention
- Early and consistent antiretroviral therapy (ART) to keep HIV under control
- HPV and Hepatitis B vaccinations
- Regular cancer screenings (Pap smears, colonoscopies, etc.)
- Safe sex practices to reduce the risk of sexually transmitted infections
- Smoking cessation
- Routine monitoring of immune function (CD4 count and viral load)
Treatment Options Korea
1. Antiretroviral Therapy (ART)
- Lifelong combination ART is the foundation of treatment
- Helps restore immune function and may reduce tumor burden
- Provided at infectious disease clinics in Korean general and university hospitals
2. Kaposi’s Sarcoma (KS)
- Caused by HHV-8 (Human Herpesvirus 8)
- Treatment includes:
- ART alone for mild, non-visceral disease
- Liposomal doxorubicin or paclitaxel for systemic disease
- Local therapy (e.g., cryotherapy, radiation) for skin lesions
3. Non-Hodgkin Lymphoma (NHL)
- Especially Diffuse Large B-cell Lymphoma and Primary CNS Lymphoma
- Treatment includes:
- CHOP or EPOCH chemotherapy regimens
- Rituximab (if CD20-positive and immune status allows)
- CNS prophylaxis or treatment as needed
- Managed in hematology-oncology departments with ART coordination
4. Invasive Cervical Cancer
- Considered AIDS-defining in women with HIV
- Managed like other cervical cancers:
- Surgical removal (early-stage)
- Radiotherapy and chemotherapy (advanced-stage)
- Regular Pap smears and HPV vaccination encouraged for prevention
5. Other Cancers in HIV-Positive Patients
- Higher risk for anal cancer, liver cancer, Hodgkin lymphoma
- Standard treatment applied but adjusted for:
- Drug interactions with ART
- Immune suppression
- Care is multidisciplinary, involving oncologists, infectious disease specialists, and pharmacists
6. Supportive and Palliative Care
- Management of opportunistic infections during cancer therapy
- Nutritional support, pain relief, and psychological counseling
- Hospice and palliative care services available in Korean cancer centers
