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n CME : Your SA Journal of CPD - HIV and childhood cancer : main article

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Abstract

HIV-related immunosuppression increases the incidence of certain forms of cancer, and HIV infection and its co-morbidities such as TB have made it more difficult to treat incidental malignancies. The HIV-related malignancies (HIVRM) include AIDS-defining cancers and HIV-associated neoplasms. The AIDS-defining cancers are Kaposi's sarcoma (KS) and B-cell lymphomas (including primary CNS lymphoma), all of which are defined as WHO stage IV or CDC category C conditions. The HIV-associated neoplasms include leiomyosarcoma (a rare smooth-muscle tumour defined as CDC category B) and mixed-cellularity Hodgkin's lymphoma (not listed by WHO or CDC). They are all the result of viral transformation of DNA in host cells, by human herpesvirus-8 (HHV8) in the case of Kaposi's sarcoma and by Epstein-Barr virus (EBV) in the others. While these tumours all occur in HIV-negative patients, the incidence of B-cell lymphoma shows a modest increase and the incidence of Kaposi's sarcoma increases tenfold or more in the presence of HIV infection. The number of incidental malignancies occurring in HIV-positive children rises as the prevalence of HIV increases in the population. This is a function of both an increase in the number of susceptible individuals and increased survival of this cohort as the number of children on antiretroviral therapy (ART) expands.

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/content/m_cme/28/7/EJC63836
2010-07-01
2016-12-03
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