5.13 Cancers: KS, NHL, cervical and other cancers

Some cancers occur more often in people who are living with HIV.

These are generally cancers that are linked to viral infections.

AIDS-defining cancer

Several important cancers are linked to HIV, and are listed as AIDS-defining illnesses. These include Kaposi’s Sarcoma (KS), Non-Hodgkins lymphoma (NHL) and cervical cancer..

Other types of cancer

Even though some other cancers occur more frequently in people living with HIV compared to the general population, they have not been categorised as AIDS-defining.

These include anal cancer, lung cancer and Hodgkins Disease.

Other cancers (eg breast cancer) that are not increased by HIV are generally not caused by viral infections.

What is cancer?

Cancer is a disease caused by uncontrolled growth and spread of abnormal cells.

Benign (in situ) cancers are contained to the original cells. As long as they do not spread, they are not dangerous.

Malignant cancers spread to other parts of the body and are much more serious. If the spread is not controlled, they can be fatal.

Lymphoma are cancers that develop in the lymphatic system. The most common type of lymphoma is Hodgkins disease (HD). All other lymphomas are called non-Hodgkins lymphomas (NHL).

Sarcoma are cancers of the bone, cartilage, fat, muscle, blood vessels, skin or other connective tissue. The most common sarcoma associated with HIV is Kaposi’s Sarcoma (KS).

Carcinoma is the name for a form of cancer that develops in tissues covering or lining organs of the body, such as the skin, the uterus, the lung, or the breast.

Main symptoms, diagnosis and treatment

Each cancer has different characteristics, symptoms and treatment. All cancers have a better outlook if they are detected early.

Apart from KS, HIV-related cancers are the one type of illnesses that do not dramatically improve and resolve as a response to HIV treatment (ART). This is why screening and early monitoring is important.

KS is unusual because if someone is not already on ART, then starting ART can make the KS go into remission, without chemotherapy for the cancer. Sometimes KS also needs to be treated directly.

Anyone with HIV and cancer needs their care team to include an HIV cancer specialist. If your hospital does not include this level of expertise, your doctor needs to contact another hospital to advise on your care.

Many HIV-related cancers are linked to other viral infections:

KS is skin cancer that can also affect other organs and is associated with HHV-8 (human herpes virus 8).
Cervical and anal cancer are both linked to HPV (human papilloma virus). HPV is a large family of viruses that also cause genital and anal warts. Some strains (16, 18, 31, 33, 35) have a stronger link to cancer than others.
Epstein-Barr virus is associated with NHL.
Liver cancer is associated with hepatitis C virus.