The session . On. HIV and cancer was a rapid overview anD quite focussed on the French experience -
HIV and cancer - DR Jen Philippe Spano -france
RIsk factors- Age, HIV, oncogenic infections (HPV, EBV, HCV, HBV, HHV8), smoking, inflammation, sun (melanoma), low CD4
cART relative risk -non AIDS cancer with inc risk - inc Hodgkins 19 RR, anus and liver and lung - often occurs at YOUNGER Age than HIV neg counterparts (Not inc risk of breast ca, prostate or colon ca)
SMOKING is the trigger for the oncogenic viral infections to have their effects;
-HIV contributes to inc risk of non aids cancer when adjust for smoking and oncogenic viral infections cf the general population;
LUNG cancer-in HIV pos pt in France, this is the highest ca diagnosed;
Screening in the Gen pop- - CT scan- false positive nodules, may lead to false pos, used for diagnosis;
One study showed (not specifically HIV pts) annual low dose CT scan was better than CXR and resulted in reduced mortality
-in France did a study in HIV pos smokers , low dose CT annually, 400 pts, 10 pts were diagnosed with lung Ca, mean CD4 high, problem is the high rate of other pulmonary comorbidities and false pos rate and biopsy, anxiety etc to investigate these further
SKIN malignancies- eg BCC, SCC - should have regular annual examination;
RFx -Sun , FH, aging
IN France, all patients in Gen population diagnosed with these cancers recommended to have HIV test .
Tagged in:
HIV Glasgow Conference 2016