Background:  Cancers have been recognized in association with HIV since the beginning of the AIDS epidemic. With the widespread use of ART, the incidence of cancers in HIV has changed with decreases in the incidence of AIDS-defining cancers, e.g., Kaposi’s sarcoma and primary central nervous system lymphoma, and increases in non-AIDS defining cancers, e.g., anal cancer, Hodgkin’s disease, and lung cancer.  Cancers have now become the second leading cause of death in HIV in many Western countries and a major cause of morbidity and mortality in resource-constrained settings.  As evidenced by the greatly improved treatment and survival of patients with AIDS and non-Hodgkin’s lymphoma, much of this improvement can be attributed to more dose-intense chemotherapy, better control of infections and treatment-related toxicities in addition to improved immunologic responses from more potent ART. In addition, advances in our knowledge of the pathogenesis of various cancers and development of new prevention approaches for certain virally-associated tumors have led to more targeted treatment and prevention for some of these cancers.

Conclusions:  Greater awareness of the problem of cancer in HIV worldwide and a higher index of suspicion for malignancies in this population can lead to earlier diagnosis and treatment. Continued clinical research into improving and optimizing the treatment of cancers and finding means to improve the immune response of individuals with HIV is essential for further progress in this field.