Aids Related Cancers And Their Treatment

This book summarizes the etiology, presentation, and treatment of the complex symptoms, infections, and opportunistic cancers of people living with HIV/AIDS. Presents therapies that strike a balance between controlling and eliminating cancer and minimizing the damage to the immune system. Illustrates points with clear and easily read figures,

The association between AIDS and cancer was recognized from the beginning of the AIDS epidemic, when the appearance of Kaposi sarcoma in a cluster of young men was one of the first signs of this new disease. It was soon recognized that AIDS was caused by infection with a novel virus (HIV) and that AIDS patients are prone to develop a number of “AIDS-defining” cancers: Kaposi sarcoma, lymphoma, and cervical cancer. The development of effective combination anti-HIV therapy starting around 1996 converted AIDS from a death sentence to a manageable disease and led to dramatic shifts in the epidemic. As this therapy was able to improve immune function in patients, the incidence of most “AIDS-defining” cancers decreased. There is a misconception, however, that AIDS has gone away. In fact, as AIDS patients are living longer, the number of AIDS patients has more than doubled in the United States since 1996, and the AIDS population overall has increased in age. Also, as AIDS patients are less likely to die of other complications, cancer is coming to the forefront as one of the most common causes of death in regions where AIDS drugs are widely available. Moreover, the three “AIDS-defining” cancers are now taking a back seat to a number of other HIV-associated cancers, such as Hodgkin lymphoma, lung cancer, and anal cancer. In the developing world, AIDS-associated cancers are a major public health problem, and in some regions of sub-Saharan Africa, Kaposi sarcoma is the most common tumor in men. In recent years, there has been a vast increase in our understanding of HIV-associated cancers. We now know, for example, that most are caused by other viruses and that the main role of HIV and immunodeficiency is to provide a supportive environment for the viruses to multiply and for the cancers to develop. But there remain a number of unanswered questions and a need for improved prevention and therapy. In the 28 chapters of this book, written by some of the most renowned experts in this field, we present up-to-date information on the cancers associated with HIV infection. The chapters cover the epidemiology of these cancers, their pathogenesis, their clinical presentation, and their treatment. The book will be of value to physicians, other medical professionals, students, and researchers with an interest in AIDS, viral-associated cancers, or HIV-associated malignancies. TABLE OF CONTENTS 1. HIV-associated Cancers: Overview Robert Yarchoan, Thomas Uldrick, Mark Polizotto 2. Epidemiology of AIDS-defining Malignancies William A. Blattner and Rebecca G. Nowak 3. Epidemiology of non-AIDS Defining Malignancies Andrew E. Grulich 4. HIV Cancers in Resource-Limited Regions Sam M. Mbulaiteye 5. Kaposi's Sarcoma-associated Herpesvirus (KSHV) Blossom Damania and Dirk P. Dittmer 6. Epstein Barr Virus (EBV) Lindsey Hutt-Fletcher 7. Human Papillomavirus (HPV) Zhi-Ming Zheng 8. Merkel Cell Polymavirus (MCV) Nicole Fischer and Adam Grundhoff 9. Presentation and Pathogenesis of Kaposi's Sarcoma Corey Casper 10. Management of Kaposi's Sarcoma Susan E. Krown 11. Presentation and Pathogenesis of HIV Lymphomas Richard F. Little, Stefania Pittaluga, Kieron Dunleavy 12. Diffuse Large B-Cell Lymphoma Neel K. Gupta and Lawrence D. Kaplan 13. Burkitt and Burkitt-Like Lymphoma Kishor Bhatia and Sam M. Mbulaiteye 14. Primary Effusion Lymphoma Giovanna Tosato 15. AIDS-related Central Nervous System Lymphoma Jan Davidson-Moncada and Thomas Uldrick 16. Plasmablastic and Other Lymphomas Huan-You Wang, Ida Wong-Sefidan, Erin Reid 17. Hodkin Lymphoma Michele Spina, Rosanna Ciancia, Accursio Augello 18. Multicentric Castelman Disease Mark N. Polizzotto, Thomas S. Uldrick, Robert Yarchoan 19. Cervical Cancer Elizabeth A. Stier 20. Anal Cancer Joel Palefsky 21. Other HPV-Associated Cancers Kristina R. Dahlstrom and Erich M. Sturgis 22. Lung Cancer in HIV Infection Deepthi Mani and David M. Aboulafia 23. Hepattocellular Carcinoma in HIV-positive Patients Massimiliano Berretta, Paolo De Paoli, Umberto Tirelli, Bruno Cacopardo 24. Merkel Cell Carcinoma and Other HIV-associated Skin Cancers Nathalie C. Zeitouni adn Bethany Lema 25. Conjuctival Carcinoma Kenneth O. Simbiri and Erle S. Robertson 26. Malignancies in Children with HIV Infection D. Cristina Stefan 27. cART and Supportive Care Ronald T. Mitsuyasu 28. Stem Cell Transplantation Christine Durand and Richard Ambinder

Cancer incidences increase in people living with HIV/AIDS. Over 2 million people currently live with HIV/AIDS in the US. This number will increase as HAART prolongs the average lifespan and as (at least in some states) the number of new HIV infections increase again. As this population ages their incidence rates for cancer will increase, as well. Recently, new rational targets for cancer therapy have emerged. But their application to the care of HIV+ patients is slow, because of concerns about the weakened immune status of the patients, because of possible drug interactions with HAART and because some of the AIDS defining cancer are rare.

The lifestyles and socio-economic status that are prevalent in regions of the world with limited resources form the background for the unique features of neoplastic diseases in these areas, where the majority of the world population lives. The predominance of the world’s retroviral burden of in these areas further compounds the nature and challenges of the cancer there. Much of the international cancer literature covers the nature and challenges of the disease as seen in high-income regions of the world, thereby giving a skewed view of the global cancer challenges. As the low- and middle-income regions of the world transition from communicable to non communicable disease patterns, there is a need for a corresponding paradigm shift, with increased emphasis on what the world needs to know about non communicable diseases, including cancer, where the disease is hitherto poorly documented. The main goal of the proposed book is to contribute to this outcomes.

One of the most important aspects of AIDS is the loss of protective immune function in the infected host which leads to increased prevalence of opportunistic infections and cancers. This book specifically addresses viral-induced human cancers associated with AIDS and observed in the AIDS population. It addresses the specific treatment required in this special population and the molecular biology of the causative viral agents.

This book presents a general introduction to and review of HIV-associated hematological malignancies, with a special focus on practical management issues. Each of the relevant malignancies is addressed individually, with an overview of treatment approaches, assessment of evidence regarding their efficacy, and discussion of therapeutic controversies. In addition, careful consideration is paid to issues in molecular and clinical pathology, epidemiological aspects, symptomatology, diagnosis, and risk factors. Separate chapters are devoted to autologous and allogeneic stem cell transplantation and to chemotherapy and interactions with antiretroviral agents. Many of the chapters are written by experts who have been instrumental in shifting the balance for people living with HIV and blood cancers. While two decades ago this diagnosis represented a death sentence, advances in treatment have transformed these cancers into often curable conditions. Nevertheless, optimal treatment of hematological malignancies remains a challenge, particularly in patients with severe immunosuppression. This book will be an invaluable source of information for all practitioners in the fields of clinical hematology and medical oncology and HIV medicine.

This book explores AIDS and malignancies, specifically the various cancers and malignant diseases that frequently occur in AIDS patients. It examines Kaposi's sarcoma, Non-Hodgkin's lymphoma, and other malignancies. This book provides thorough coverage for physicians and researchers alike. Addresses critical research and clinical issues. Includes chapters devoted to care and treatment of AIDS and HIV patients with malignant diseases.