12 Jun Long Term HIV Viral Suppression Reduces But Does Not Eliminate Elevated Cancer Risk
MedicalResearch.com Interview with:
Dr. Lesley Park
Lesley S. Park, PhD, MPH
Instructor, Medicine- Primary Care and Population Health
BioStanford Center for Population Health Sciences (PHS) Associate Director, Research and Data Strategy; Director, PHS Postdoctoral Fellowship
Veterans Aging Cohort Study (VACS) Cancer Core Co-Director
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As the population of persons living with HIV/AIDS is aging, the overall burden of cancer is substantial and increasing; however, we have much to learn about the potential cancer prevention benefits of antiretroviral treatment (ART).
Our study is the first to examine the effects of prolonged periods of viral suppression and potential cancer prevention benefits. While prior randomized clinical trials (RCTs) and observational studies have examined viral suppression and cancer risk, they mostly were limited to small numbers of cancer outcomes or were only focused on few specific cancer types.
Our study demonstrated a benefit of the prevention of cancer development in AIDS-defining cancers (non-Hodgkin lymphoma, Kaposi sarcoma), which was expected, but also in some non-AIDS-defining cancer types (lung, larynx, melanoma, leukemia).
MedicalResearch.com: What should readers take away from your report?
Response: Antiretroviral therapy resulting in long-term viral suppression may contribute to cancer prevention, to a greater degree for AIDS-defining cancers than for non-AIDS-defining cancers. Patients with long-term viral suppression still had excess cancer risk. These findings are helpful to both infectious disease and general medicine clinicians who care for the population of aging HIV+ patients and especially to HIV+ patients. Clinicians and patients should be even more motivated to adhere to treatment to achieve long-term viral suppression.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: These findings establish the scientific evidence to warrant further exploration of the effects of long term viral suppression in future work that explores lower thresholds or varying duration of suppression.
MedicalResearch.com: Is there anything else you would like to add?
Response: Increasingly, we are recognizing that many cancers are driven by viruses. Understanding how HIV interacts with viral coinfections and results in higher risks of cancer may offer critical insight in how we might better prevent and treat these cancers for everyone.
No disclosures to report.
Citation:
Association of Viral Suppression With Lower AIDS-Defining and Non–AIDS-Defining Cancer Incidence in HIV-Infected Veterans
A Prospective Cohort Study
Lesley S. Park, PhD, MPH; Janet P. Tate, ScD, MPH; Keith Sigel, MD, MPH; Sheldon T. Brown, MD; Kristina Crothers, MD; Cynthia Gibert, MD; Matthew Bidwell Goetz, MD; David Rimland, MD; Maria C. Rodriguez-Barradas, MD; Roger J. Bedimo, MD; Amy C. Justice, MD, PhD; Robert Dubrow, MD, PhD
Published: Ann Intern Med. 2018.
DOI: 10.7326/M16-2094
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Last Updated on June 12, 2018 by Marie Benz MD FAAD