Panel B shows estimated numbers of cancers among people living with AIDS in the United States according to year, stratified according to AIDS-defining cancers, non–AIDS-defining cancers, and poorly specified cancers. Data are from the National HIV Surveillance System, Centers for Disease Control and Prevention. Panel A shows the AIDS population in the United States according to year and age group. Trends in AIDS and in Cancers among Persons with AIDS. As shown in a study in France, cancer is the leading cause of death in HIV-infected persons in highly developed countries. 3, 4, 6, 7 The burden of AIDS-defining cancers has remained relatively steady for the past two decades, but the burden of non–AIDS-defining cancers has increased and accounts for an increasing proportion of cancer-related morbidity and mortality in this population ( Fig. A large proportion of persons with HIV infection or AIDS are currently at an age at which the risk of cancer is increased, and a wide variety of cancers now develop in patients with HIV infection in association with a range of CD4+ counts. 4, 5 However, as combination ART has dramatically improved the survival of patients with HIV infection and AIDS, the number of persons living with AIDS has more than doubled in the United States and the age of this population has increased ( Fig. The incidence dropped by 70% or more in the United States after the introduction of three-drug antiretroviral therapy (ART) regimens in the mid-1990s, with a continued and more modest decrease after 2000. After the introduction of zidovudine and didanosine, the incidence of these tumors began to decrease. Before the development of effective anti-HIV therapy, these cancers occurred in 30% or more of patients who had AIDS. Kaposi’s sarcoma and several types of aggressive B-cell lymphomas occur most often in patients with CD4+ T-cell lymphocytopenia. Epidemiology and Pathogenesis of HIV-Associated Cancers
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