A Complex of AIDS & Cancer | Dr. Vashishth Maniar | Cancer Specialist | MOC
Kaposi's Sarcoma, a rare form of skin cancer was found in few homosexual men in 1981 and introduced to the medical fraternity a newly identified medical condition called AIDS related Kaposi's Sarcoma. It went to an extent of being identified as an 'AIDS defining cancer'. Extensive research has gone into establishing a link between HIV & Cancer. Acquired Immno-Deficiency Syndrome (AIDS) is a manifestation of a virus named Human Immuno-Deficiency Virus that enters into human body and damages the immune system. HIV can remain present in the body for a long time before it can cause significant damage to the immune system in human beings. The said damage to the immune system can be explained as lowering the count of CD4+ T cells that helps fight infection in the body. Till the time AIDS becomes clinically evident (begins showing symptoms), the person infected with HIV remains a carrier of HIV & this makes such carriers susceptible to catching infection by cancer causing viruses like Kaposi's Sarcoma Herpvirus or Human Papillomavirus.
For many years now, Non-Hodgkins Lymphoma and Cervical Cancer are also observed in people with HIV / AIDS and happened to be termed as AIDS defining cancers. It implies that when a person is diagnosed with one of these cancers, AIDS has likely developed. AIDS has been treated with combination antiretroviral treatment (cART) for over 2 decades and it has efficiently fought HIV and maintained the immune system of patients working fine against the risk of cancer-causing viruses and otherwise.
AIDS related Kaposi's Sacroma is predominantly a disease of the western society. In India, the incidences of Kaposi's Sarcoma are rare though the burden of AIDS in India is almost the second, next to sub-saharan Africa and Human Herpvirus- 8 which is a Kaposi's Sarcoma related virus is known to be prevalent here. On a contrary, Lung Cancer, Liver Cancer, Hodgkin's Lymphoma, Anal Cancer & Head & Neck Cancer are some of the non-AIDS defining cancers and they are quite common in HIV-positive population. Risk factors for these cancers are smoking, chronic inflammation due to HIV and presence of other viruses like Epstein-Barr Virus, Hepatitis B & C etc.
Cancer screening has a pivotal role in improving outcomes in patients with HIV related cancers. It is recommended for example that those women identified to be HIV-positive should get the PAP smear test done every year to screen themselves for cervical cancer. After 3 consecutive normal PAP tests, the frequency of screening in such women can be reduced to every 3 years.
It is important that those diagnosed as HIV positive should take their combination anti-retroviral treatment without any disruption in order to reduce the risk of cancer-causing viruses & other infections. For those with such HIV related cancers, infection treating team of doctors and oncologists / cancer specialists work together in a multidisciplinary fashion to offer patients an optimal management plan to control both the diseases.
Dr. Vashishth Maniar, MD DM ECMO
Consultant Medical Oncologist / Cancer Specialist
Mumbai Oncocare Centre, Ghatkopar
9984899700 | 9769707204 | 022-21020017