People with untreated HIV can be at higher risk of a wide range of infection-related cancer types. The ageing of the population with HIV means that even in treated patients, cancer may soon become one of the leading causes of morbidity (illness) and mortality (death) in people with HIV. Recent research shows that immune deficiency is the probable explanation for the increased cancer risk; suggesting a broader than previously appreciated role for the immune system in the prevention of cancers related to infections.
For men who have sex with men, cellular changes in the genitals and anus, including those caused by the human papillomavirus (HPV) — the virus that causes warts — sometimes leads to anal cancer. This is more common in HIV-positive men and especially those with a low CD4 count.
For women, abnormalities in cervical cells, including those caused by HPV, and cervical cancer can occur regardless of HIV status. They are more common in women with HIV, and can be more invasive.
What can you do?
Cancer prevention is possible
Maintenance of optimal immune function through HIV treatment will prevent many HIV-associated cancers. How high we should aim in terms of CD4 cell counts is an unknown factor at this stage, but will hopefully be answered by currently planned studies of the early treatment of HIV infection.
Smoking cessation — the other top priority
Smoking can weaken your overall immune system — placing people with HIV who smoke at greater likelihood of getting some opportunistic infections and AIDS-defining illnesses in patients with a low CD4 count.
Smokers who are HIV positive are much more likely to develop many of the conditions linked to smoking than those that are HIV negative, with most of these conditions rarely occurring among non-smokers.
People with HIV are also at significantly increased risk of heart disease, with HIV infection and ARV treatments already contributing to this increased risk. HIV-positive smokers are also at increased risk of different kinds of cancers.
If you smoke, then quitting is the single most effective way to improve your health.
Screening for the early detection of cancer is the same as it is for the general population, except for:
- men who have sex with men (those over 40 should talk to their doctor about getting an anal cancer check)
- women with HIV should get a pap smear every year.
Speak to your doctor for more information about these and other types of cancer you may be at higher risk of, and about whether a vaccination for HPV would be effective for you.