The Possible Link Between Mesothelioma and HIV/AIDS
HIV and AIDS are scary diseases, but they are no longer death sentences thanks to the extensive research that has developed better treatments and therapies to manage HIV like a chronic illness. Even with these treatments, though, there are still serious consequences of living with HIV and a compromised immune system, including an increased risk of developing cancer, including mesothelioma.
Individual case studies have illustrated that patients with HIV may develop mesothelioma, either without any asbestos exposure or rapidly after being exposed. Researchers need to have a better understanding of this connection, but it is currently believed that the suppression of the immune system and damage caused it by HIV is what makes someone more susceptible to this and other cancers.
What Are HIV and AIDS?
HIV stands for human immunodeficiency virus and is also the name for the infection caused by this virus. HIV is transmitted sexually, through blood, and from mother to child during pregnancy, childbirth, or breast feeding. It attacks and damages the immune system once in the body and impedes the body’s ability to fight off other pathogens and illnesses.
Over many years the damage to the immune system from HIV can cause someone to develop AIDS, acquired immunodeficiency syndrome. AIDS is chronic and life-threatening. It occurs when the immune system is so damaged that the body cannot fight off any infections. People with AIDS often die from opportunistic, secondary infections.
Cancer in Patients with HIV
A connection between HIV and certain cancers has already been established. For instance, Kaposi’s sarcoma is a type of cancer that is extremely rare in people without HIV. It is, however, common in people who are HIV positive. This kind of cancer attacks the walls of blood vessels and causes pink and red lesions on the skin and inside the mouth.
Also fairly common in people with HIV are B-cell non-Hodgkin lymphoma, and cervical cancer in women. People with HIV are 500 times more likely to develop Kaposi’s sarcoma, 12 times more likely to have lymphoma, and three times more likely to have cervical cancer. In addition to these cancers, HIV-positive patients are also more susceptible to cancer in general and have an elevated risk of developing liver cancer, anal cancer, and lung cancer. These other cancers are considered non-AIDS-defining cancers.
The relationship is likely related to the weakening of the immune system caused by HIV. The immune system has some role to play in defending against the body generally. More specifically, there are viruses that cause cancer that people with HIV are less able to fend off, including Epstein-Barr virus, Kaposi sarcoma-associated herpesvirus, hepatitis viruses, and human papilloma viruses. Another explanation may be that risk factors for cancer, like smoking and heavy drinking, are more prevalent in people with HIV.
HIV and Mesothelioma Risk
If there are no statistics about an increased risk of developing mesothelioma for HIV-positive patients, it may only be because this is a rare type of cancer. There are several individual case studies, however, that do show patients with HIV developing mesothelioma. In some cases the patients were never exposed to asbestos as far as they knew. In others the patients were exposed to asbestos but then developed mesothelioma rapidly, over months instead of the decades it normally takes.
One of these case studies describes a 41-year-old HIV-positive man who was exposed to asbestos just six months before developing respiratory symptoms and being diagnosed. For this patient, a case can be made that his immune system damage caused by HIV made him not only more susceptible to mesothelioma, but caused the cancer to develop more rapidly than it normally would.
The researchers who studied this particular patient refer to other case studies in which patients with an SV-40 infection, who had undergone an organ transplant, or who were elderly developed mesothelioma. In all of these cases the patients had suppressed or weakened immune systems, which suggests that immunosuppression is a significant risk factor for mesothelioma. More research is needed to determine more specifically how mesothelioma develops in patients like these. That study could help lead to better early diagnosis of the cancer and even better ways of protecting people who work around asbestos.
HIV as Cancer Cure
A positive test for HIV is no longer the death sentence it once was. This is because researchers have developed better and better drugs to treat the infection and to manage it over the long-term. There is no cure, but medications can keep the infection at bay and prevent the development of AIDS. The extensive research that has helped to better understand the virus and to develop medications and immune system therapies to act against it has led to additional discoveries.
One of these may be a new treatment for cancers of all types, and a new hope for people with difficult-to-treat cancers like mesothelioma. HIV researchers developed an immunotherapy treatment that involves taking the patient’s T-cells, immune system cells, out of the body and modifying their genetic material using a virus. This modification turns instructs the T-cells to go after the virus in the body once they are re-injected.
The same type of therapy has been used to treat some patients with cancer. The T-cells were modified using an HIV-related virus and then put back into the patients. So far trials have been small but promising. Some patients saw a return of their cancer, but even more experienced complete remission. This could be a very promising future treatment for other types of cancer that are difficult to treat, including mesothelioma.
Living with HIV is difficult and has a lot of consequences for a patient’s health, even with early and good treatment. One of those is the elevated risk for cancer. Now there is evidence that even mesothelioma may be a risk for people with HIV. The immune system may be the culprit, but researchers are also finding ways to use the virus and the immune system together to treat both HIV and cancers like mesothelioma.
Page edited by Dave Foster
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