Date of this Version
The first documented cases of acquired immunodeficiency syndrome (AIDS) were characterized by the presence of rare Kaposi’s sarcoma (KS) skin lesions. More than 10 years later, it was discovered that the causative agent of KS was a γ-herpesvirus, human herpesvirus-8 (HHV-8) (KS-associated herpesvirus, KSHV). It is now abundantly clear that cancers induced by viral agents [such as, Epstein-Barr virus (EBV) and human papillomavirus (HPV)] are exacerbated by human immunodeficiency virus (HIV) infection and subsequent immune suppression. For example, the incidence of and primary central nervous system (CNS) lymphoma (PCNSL) and Hodgkin’s and high grade B-cell non-Hodgkin’s lymphomas (NHL), nasopharyngeal carcinoma (NPC), anal, penile, oral, and invasive cervical carcinomas are much higher in AIDS patients. Also common in the AIDS-afflicted, are hematopoietic cancers, B- and T-cell lymphomas, myelosarcomas, lung cancers, and gastrointestinal tract cancers. The development of highly active antiretroviral therapy (HAART) has proved effective in inducing regression of PCNSL, NHL, KS, and other cancers caused by viruses, extending the life span and quality of life of AIDS patients. However, the general availability of HAART and other antiretrovirals in developing countries, where most HIV infections are reported, is still poor. Furthermore, several reports indicate that HAART is not effective in reversing HPV-induced cervical cancers, for unknown reasons. The development of the prophylactic HPV vaccine offers some hope that future generations can be protected against cervical and penile cancers. However, in countries with high rates of cervical cancers, such as in sub-Saharan Africa, the rate of HIV-positivity approaches 30%, antiretrovirals are scarce, and the HPV vaccine is not available, nor would it be effective for those already infected with HPVs. Thus, better methods of surveillance and management of these malignancies in HIV-positive individuals continues to be a need.