Limits...
Cancer risk in persons with HIV/AIDS in India: a review and future directions for research.

Biggar RJ, Chaturvedi AK, Bhatia K, Mbulaiteye SM - Infect. Agents Cancer (2009)

Bottom Line: In contrast, Kaposi sarcoma is rare, in association with an apparently low prevalence of Kaposi sarcoma-associated herpesvirus.The association may be confounded by sexual behaviors that transmit both HIV and human papillomavirus.Based on limited evidence, the increase is at buccal/palatal sites, which are associated with tobacco and betel nut chewing rather than human papillomavirus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Research, LV Prasad Eye Hospital, Hyderabad, India. rjbiggar@gmail.com

ABSTRACT

Background: India has a large and evolving HIV epidemic. Little is known about cancer risk in Indian persons with HIV/AIDS (PHA) but risk is thought to be low.

Methods: To describe the state of knowledge about cancer patterns in Indian PHA, we reviewed reports from the international and Indian literature.

Results: As elsewhere, non-Hodgkin lymphomas dominate the profile of recognized cancers, with immunoblastic/large cell diffuse lymphoma being the most common type. Hodgkin lymphoma is proportionally increased, perhaps because survival with AIDS is truncated by fatal infections. In contrast, Kaposi sarcoma is rare, in association with an apparently low prevalence of Kaposi sarcoma-associated herpesvirus. If confirmed, the reasons for the low prevalence need to be understood. Cervical, anal, vulva/vaginal and penile cancers all appear to be increased in PHA, based on limited data. The association may be confounded by sexual behaviors that transmit both HIV and human papillomavirus. Head and neck tumor incidence may also be increased, an important concern since these tumors are among the most common in India. Based on limited evidence, the increase is at buccal/palatal sites, which are associated with tobacco and betel nut chewing rather than human papillomavirus.

Conclusion: With improving care of HIV and better management of infections, especially tuberculosis, the longer survival of PHA in India will likely increase the importance of cancer as a clinical problem in India. With the population's geographic and social diversity, India presents unique research opportunities that can be embedded in programs targeting HIV/AIDS and other public health priorities.

No MeSH data available.


Related in: MedlinePlus

High HIV prevalence areas of India. Map A. HIV prevalence in India, by district. (Reproduced from Chandrasekaran, et al2, with Journal permission.) ANC = Antenatal Clinics. Map B. Cities mentioned in the text. Grey areas indicate where the prevalence in women attending antenatal clinics was >1% in 2005 (data approximated from Map A).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2667414&req=5

Figure 1: High HIV prevalence areas of India. Map A. HIV prevalence in India, by district. (Reproduced from Chandrasekaran, et al2, with Journal permission.) ANC = Antenatal Clinics. Map B. Cities mentioned in the text. Grey areas indicate where the prevalence in women attending antenatal clinics was >1% in 2005 (data approximated from Map A).

Mentions: In a country as large and diverse as India, the size of the HIV/AIDS epidemic is difficult to estimate. The most recent UNAIDS Report on the Global AIDS Epidemic estimated 2.5 million persons were prevalently HIV-infected as of 2007 [1]. Although HIV prevalence appears to be stable, much remains uncertain about the direction of the epidemic. Geographically, higher prevalence (2 – 3% of antenatal women) occurs in south-central and north-eastern India (Figure 1), with higher risks in migratory and underprivileged populations [2]. Transmission in adults is predominantly heterosexual but injection drug users and men who have sex with men are also major transmission groups in some areas. In this report, we summarize what is known about the cancer experience among Indian persons with HIV/AIDS (PHA).


Cancer risk in persons with HIV/AIDS in India: a review and future directions for research.

Biggar RJ, Chaturvedi AK, Bhatia K, Mbulaiteye SM - Infect. Agents Cancer (2009)

High HIV prevalence areas of India. Map A. HIV prevalence in India, by district. (Reproduced from Chandrasekaran, et al2, with Journal permission.) ANC = Antenatal Clinics. Map B. Cities mentioned in the text. Grey areas indicate where the prevalence in women attending antenatal clinics was >1% in 2005 (data approximated from Map A).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667414&req=5

Figure 1: High HIV prevalence areas of India. Map A. HIV prevalence in India, by district. (Reproduced from Chandrasekaran, et al2, with Journal permission.) ANC = Antenatal Clinics. Map B. Cities mentioned in the text. Grey areas indicate where the prevalence in women attending antenatal clinics was >1% in 2005 (data approximated from Map A).
Mentions: In a country as large and diverse as India, the size of the HIV/AIDS epidemic is difficult to estimate. The most recent UNAIDS Report on the Global AIDS Epidemic estimated 2.5 million persons were prevalently HIV-infected as of 2007 [1]. Although HIV prevalence appears to be stable, much remains uncertain about the direction of the epidemic. Geographically, higher prevalence (2 – 3% of antenatal women) occurs in south-central and north-eastern India (Figure 1), with higher risks in migratory and underprivileged populations [2]. Transmission in adults is predominantly heterosexual but injection drug users and men who have sex with men are also major transmission groups in some areas. In this report, we summarize what is known about the cancer experience among Indian persons with HIV/AIDS (PHA).

Bottom Line: In contrast, Kaposi sarcoma is rare, in association with an apparently low prevalence of Kaposi sarcoma-associated herpesvirus.The association may be confounded by sexual behaviors that transmit both HIV and human papillomavirus.Based on limited evidence, the increase is at buccal/palatal sites, which are associated with tobacco and betel nut chewing rather than human papillomavirus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Research, LV Prasad Eye Hospital, Hyderabad, India. rjbiggar@gmail.com

ABSTRACT

Background: India has a large and evolving HIV epidemic. Little is known about cancer risk in Indian persons with HIV/AIDS (PHA) but risk is thought to be low.

Methods: To describe the state of knowledge about cancer patterns in Indian PHA, we reviewed reports from the international and Indian literature.

Results: As elsewhere, non-Hodgkin lymphomas dominate the profile of recognized cancers, with immunoblastic/large cell diffuse lymphoma being the most common type. Hodgkin lymphoma is proportionally increased, perhaps because survival with AIDS is truncated by fatal infections. In contrast, Kaposi sarcoma is rare, in association with an apparently low prevalence of Kaposi sarcoma-associated herpesvirus. If confirmed, the reasons for the low prevalence need to be understood. Cervical, anal, vulva/vaginal and penile cancers all appear to be increased in PHA, based on limited data. The association may be confounded by sexual behaviors that transmit both HIV and human papillomavirus. Head and neck tumor incidence may also be increased, an important concern since these tumors are among the most common in India. Based on limited evidence, the increase is at buccal/palatal sites, which are associated with tobacco and betel nut chewing rather than human papillomavirus.

Conclusion: With improving care of HIV and better management of infections, especially tuberculosis, the longer survival of PHA in India will likely increase the importance of cancer as a clinical problem in India. With the population's geographic and social diversity, India presents unique research opportunities that can be embedded in programs targeting HIV/AIDS and other public health priorities.

No MeSH data available.


Related in: MedlinePlus