Question
What are the risks of non-HIV cancers?
9 October 2008. Related: All topics, CD4 and viral load, Opportunistic infections.
Hi
I am a 37 yr old gay male who has been diganosed with HIV 6 months ago and estimate I could have contracted the infection anything up to 2 years ago – my CD4 has gone from 360 to 480 over the last six months and my viral load is 50 copies/mL.
I am not on treatment as yet and my HIV consultant says there is no rush to start treatment until my CD4 drops to 350.
My questions are:- could i continue to expect a rise in CD4 without treatment and is this usual ?
I am increasingly concerned about the risk of non-HIV cancers and was wondering what the ‘real’ risks where with a reasonable CD4?
Answer
CD4 counts vary a lot between different people, and it is not unusual, after a recent infection, for them to remain stable or even increase during the first few years.
As for whether your CD4 count will keep on increasing-it is hard to tell. There are many people who are in the same situation, namely having a high count for several years, before the drop starts. Hopefully it will be the same with you.
Both HIV-related and non-HIV related cancers are generally rare at higher CD4 counts. Some are more common if you are HIV-positive (which may mean that there are actually related to HIV). Several studies have shown that rates are lower for some cancers may be lower if you are on treatment, but the actual rates are still very low.
An interesting study about the risk of non-AIDS defining illnesses and in particular non-AIDS malignancies is: Baker J et al. HIV-related immune suppression after ART predicts risk of non-opportunistic diseases: results from the FIRST study. Fourteenth Conference on Retroviruses and Opportunistic Infections, Los Angeles, abstract 37, 2007. http://www.retroconference.org/2007/Abstracts/28667.htm
The researchers found that the risk of non-AIDS defining illnesses decreased by around 16% for every 100 cell increment in CD4 cell count (HR 0.84, p<0.01), while the risk of AIDS-defining events fell by 43% for every 100 cell increment in CD4 cell count (HR 0.57, p<0.01).
The CASCADE study uses large databases to look at the risk of all causes of mortality, including cancers, and reported in one analysis that the risks in the first five years after dignosis are similar to HIV-negative people.
Hope this helps.
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