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Editorial: HIV and cancer
| Last updated: 25.08.04 |
In this month’s lead article, Michael Carter talks to cancer specialist Dr. Mark Bower about the interaction between HIV, HAART and cancer. It’s not an easy subject to think about, and some readers may find the article particularly sobering.
But there is some good news, particularly for women and HIV, and not just because it appears that cervical cancer is now being seen less often in HIV-positive women in the UK who are on successful anti-HIV therapy. It also seems to be the case that being infected with HIV appears to make the incidence of breast cancer in women less likely; news that is both surprising and welcome.
For men, however, the increased incidence of anal cancer is a concern. It is currently one of the three most common non-AIDS defining illnesses amongst HIV-positive gay and bisexual men, but when caught early enough, like cervical cancer, it is completely preventable.
Until recently, it was assumed that human papilloma virus (HPV) - the virus associated with both vaginal and anal cancer - was acquired in men sexually through receptive anal intercourse. But last year French investigators found that almost half of the HIV-positive heterosexual men in their study were also infected anally with HPV.
The researchers conclude that “anal HPV infection...may be acquired in the absence of anal intercourse in HIV-positive men” and suggest that “all HIV-positive men with CD4 cell counts less than 500 cells/mm3, regardless of history of anal intercourse, should be considered” for anal pap smears.
Currently, HIV clinics in the UK rarely carry out routine anal pap smears. Perhaps it’s time for a rethink.