The prevalence of HIV in the United States continues to rise as a result of the combined effects of a declining HIV death rate and a sustained rate of new infections. Furthermore, HIV-infected patients on antiretroviral therapy can expect to live nearly almost as long as uninfected persons (within 5 years) providing ample time for individuals to develop AIDS-associated and non–AIDS-associated hematologic and oncologic conditions. HIV-infected individuals remain at increased risk of AIDS-defining malignancies such as Kaposi sarcoma, aggressive non-Hodgkin lymphoma, primary CNS lymphoma, and invasive cervical cancer and several non–AIDS-defining malignancies, including Hodgkin lymphoma, as well as anemia and thrombocytopenia. When individuals present with any of these hematologic or malignant illnesses, it should be the standard of care to obtain HIV testing to provide optimal treatment for both the presenting illness and the HIV.
Acronyms and Abbreviations
ABVD, doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine; ADAMTS 13, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13; AIDS, acquired immunodeficiency syndrome; AMC, AIDS Malignancy Consortium; ART, antiretroviral therapy; AVD, doxorubicin (Adriamycin), vinblastine, dacarbazine; BEACOPP, bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine, procarbazine, prednisone; BFU-E, burst-forming unit–erythroid; bNAbs, broadly-neutralizing antibodies; CDC, Centers for Disease Control and Prevention; CFU-GM, granulocyte-macrophage colony-forming unit; CFU-GEMM, granulocyte-erythrocyte-monocyte and megakaryocyte colon-forming unit; CHOP, cyclophosphamide, doxorubicin, vincristine, prednisone; CHORUS, Collaboration in HIV Outcomes Research/U.S. study; CMV, cytomegalovirus; CNS, central nervous system; COCOMO, Copenhagen Comorbidity in HIV Infection; CODOX-M/IVAC, cyclophosphamide, vincristine, doxorubicin, methotrexate/ifosfamide, mesna, etoposide, cytarabine; CRF, circulating recombinant form; CSF, cerebrospinal fluid; CRISPR, clustered regularly interspaced short palindromic repeats; CTL, cytotoxic T-lymphocyte; DHHS, Department of Health and Human Services; DLBCL, diffuse large B-cell lymphoma; EBV, Epstein-Barr virus; ECOG, Eastern Cooperative Oncology Group; EPOCH, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin; EPOCH-RR, EPOCH with two doses of rituximab per cycle; ESHAP, etoposide, methylprednisolone, high-dose cytarabine, cisplatin; FDA, Food and Drug Administration; G6PD, glucose-6-phosphate dehydrogenase; HHV8, human herpesvirus-8; HIV, human immunodeficiency virus; HPV, human papilloma virus; HSV, herpes simplex virus; HUS, hemolytic-uremic syndrome; hyperCVAD, cyclophosphamide, vincristine, doxorubicin, dexamethasone; Ig, immunoglobulin; IL, interleukin; IRIS, immune reconstitution inflammatory syndrome; ITP, idiopathic thrombocytopenic purpura; KICS, KSHV-associated inflammatory cytokine syndrome; KSHV, Kaposi sarcoma-associated herpesvirus; LDH, lactate dehydrogenase; LPS, lipopolysaccharide; MRI, magnetic resonance imaging; NCCN, National Comprehensive Cancer Network; NHL, non-Hodgkin lymphoma; nnRTI, nonnucleoside reverse transcriptase inhibitor; nRTI, nucleoside reverse transcriptase inhibitor; PCR, polymerase chain reaction; PEL, primary effusion lymphoma; PET-CT, positron emission tomography–computed tomography; PrEP, preexposure prophylaxis; PWID, people who inject drugs; R-CHOP, rituximab plus CHOP; R-EPOCH, rituximab plus EPOCH; SEER, Surveillance, Epidemiology, and End Results Program; SIV, simian immunodeficiency virus; TTP, thrombotic thrombocytopenic purpura; U = U, Undetectable = Untransmittable initiative.
HIV-1, the virus that causes AIDS, is a lentivirus that originated as a simian immunodeficiency virus (SIV) in chimpanzees and entered the human population in the early 20th century in equatorial Africa.1,2 First isolated in 1983,3,4 HIV-1 actually comprises four distinct viruses (types ...