Second primary cancer in people with HIV
Menée aux Etats-Unis à partir de données portant sur 22 623 personnes infectées par le VIH sur la période 1990-2010, cette étude analyse le risque de premier et de second cancer, classant et non-classant SIDA, sur la période 1985-2013
In The Lancet HIV, Nancy Hessol and colleagues summarise the changes in cancer occurrence driven by the benefits of antiretroviral therapy (ART) in people with HIV from 1985 to 2013 in the USA. Their results show a shift from the predominance of Kaposi sarcoma and non-Hodgkin lymphoma to an approximate equivalence between the incidence of AIDS-defining cancers and that of other malignancies (non-AIDS-defining cancers). The authors also highlight a new facet of the HIV epidemic. HIV-infected people have a heightened risk for both several types of first primary cancers and some second primary cancers. Among 22 623 people with HIV from San Francisco, there were 4144 first cancers and 401 higher-order cancers, of which 372 were second cancers. The high frequency of multiple cancers in the general US population is well recognised; one report found 25% of older cancer patients (aged ≥65 years) and 11% of younger cancer patients (aged <65 years) had a history of previous cancer. Similarly, in this study, 9% of all primary cancers among still relatively young people (15–64 years old) with HIV were not the first primary cancer.
The Lancet HIV , éditorial, 2017