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Invited Commentary |

An Appraisal of Non–AIDS-Defining Cancers:  Comment on “Spectrum of Cancer Risk Late After AIDS Onset in the United States”

Dirk P. Dittmer, PhD
Arch Intern Med. 2010;170(15):1345-1346. doi:10.1001/archinternmed.2010.250.
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In recent years, more and more persons infected with HIV in the United States have developed non–AIDS-defining cancers (NADCs) despite consistent and successful HAART. This phenomenon cannot be ascribed to simply an age effect, ie, that more persons infected with HIV live longer and consequently reach an age where the risk for spontaneous cancers increases exponentially. This is not true. In the most extensive analysis to my knowledge yet undertaken, Simard et al demonstrate that HIV confers an increased cancer risk independent of other factors, including age. Notably, their study calculates cancer risk for the 1996-2006 period. Since this is the time of widespread available triple therapy, it is unlikely that the trends they have documented will change appreciably because of better HAART or better HAART adherence alone. The NADCs are here to stay.

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