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People with HIV and Cancer Less Likely to Get Cancer Treatment

August 16, 2016

More than 1.2 million Americans live with HIV, according to the Centers for Disease Control and Prevention.

HIV is now no longer as fatal as it once was, as millions of people now live with the disease thanks to advances in treatment. However, a new study indicates that HIV patients with cancer still face a significant challenge with their health.

The study, conducted by researchers from the University of Utah School of Medicine, indicates  that HIV patients who also have cancer are less likely to get treatment for the latter disease. 

For the study, researchers examined a database of people diagnosed with cancer in the U.S. over an eight-year period. The database included 10,000 HIV patients who also had cancer and more than 2.2 million cancer patients who did not have HIV. 

Researchers found that people with HIV were more likely to have anal cancer and Hodgkin’s lymphoma, a type of blood cancer. There also were differences in treatment rates between HIV patients with cancer and those who only had cancer: the first group was two or three times more likely to not get any cancer treatment compared to cancer patients who didn’t have HIV.

This disparity existed even when researchers looked at whether people had insurance. Even with private insurance, HIV patients with cancer were less likely to get treatment. 

People with HIV now can live a long life with the disease and remain healthy, but the infection also puts them at greater risk for what we call AIDS-defining conditions, including cervical cancer; Kaposi's sarcoma, a type of skin cancer; and Non-Hodgkin lymphoma, a cancer that starts in the body’s immune system.  These cancers likely occur because a person with HIV has a weakened immune system. The development of these cancers may indicate that the disease has progressed from HIV to AIDS.

It’s still not clear why HIV patients with cancer are less likely to get treatment, but it could be because these patients choose not to get cancer treatment or because there’s a concern that the side effects of cancer treatment may negatively impact their HIV treatment or long-term survivorship. 

However, even when a person has two distinct illnesses, he or she should receive treatment. In the medical field, we’ve come a long way with our coordinated care efforts, so it’s possible for oncologists and HIV specialists to work together to help a patient who has both diseases. It is important to thoroughly evaluate each individual on a case-by-case basis and that it requires a team of professionals to care for these patients. Unfortunately, there aren’t any HIV-specific guidelines for cancer treatment, but care coordination can help to pinpoint potential adverse drug interactions between cancer and HIV drugs and whether certain treatment plans for one disease may affect the efficacy of the other. 

We need to understand what is causing HIV patients with cancer not to seek treatment. The study’s author, Dr. Gita Suneja, said this is a growing crisis and that “cancer is quickly becoming the leading cause of death in HIV-infected patients.” HIV rates have declined 19 percent over the last decade, according to the CDC. Advances in medicine have made HIV a manageable chronic illness rather than a fatal disease, so the medical community must do more to ensure that these patients — who now have more hope for survival — don’t succumb to another disease like cancer that could be better managed with consistent treatment.

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