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Introduction to HIV and cancer Simon Collins HIV i-Base

This introduction explores the intersection of HIV and cancer, touching on risk factors, treatment complexities, and the importance of expert care. Gain insights into the scientific concepts and activist agendas surrounding these health conditions. Learn about the challenges of diagnosing and managing cancer in individuals living with HIV, emphasizing the need for personalized health priorities. Discover the resources available for support and guidance in navigating HIV and cancer care.

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Introduction to HIV and cancer Simon Collins HIV i-Base

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  1. Introduction to HIV and cancer Simon Collins HIV i-Base

  2. Introduction • Area of expert care – referrals and networks • BHIVA guidelines • Personal aims for the day? • HIV and cancer – general points • HIV and cancer – scientific concepts • Activist agenda? • Personal comments

  3. HIV and cancer • We are lucky to be ageing… • But cancer is often an age-related disease - highest risk comes with age • >75% of people have a lifetime cancer risk - is this a natural ageing process? • Over 200 cancers – each very specific • Many are treatable, with high (>90%) remission rates if detected early (screening / surveillance / self monitoring etc) • Some are not - make the most of life.

  4. HIV and cancer • Expert care essential • Cancer treatment is very different to ART - less data for modified combinations, best guess approach. • Extended timelines for progression, treatment and treatment outcomes. • Risks are multi-factorial and often related to modifiable lifestyle factors. • Personal perspective - prioritise your health.

  5. HIV and cancer: scientific issues • Difficulty of knowing any independent risk from HIV – impact of ART/non- ART and viral suppression. • Difficultly of not having an appropriate matched control group. • Higher rates reported for some and at earlier age – but adjusting for cohort ages of reduced the differences in both incidence and age at diagnosis.

  6. HIV and cancer: scientific issues • Relative vs absolute risks • Issues of screen and risk/benefit balance with screening. • Common sense approach for broad screening programmes is not always supported by evidence. • Difficulty of separating earlier diagnosis and mortality. • Activist role/agenda

  7. Thanks Further info • Macmillan http://www.macmillan.org.uk • BHIVA malignancy guidelines http://www.bhiva.org/Guidelines.aspx UK-CAB reading for April 2013 meeting, including: • Do cancer patients with HIV die sooner? – Mark Bower.
http://www.bhiva.org/121004MarkBower.aspx

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