Impact of Antiretroviral Therapy on Cancer Treatment Outcomes among People Living with HIV in Low- and Middle-Income Countries: a Systematic Review

Curr HIV/AIDS Rep. 2021 Apr;18(2):105-116. doi: 10.1007/s11904-021-00542-5. Epub 2021 Feb 2.

Abstract

Purpose of review: The relationship between antiretroviral therapy (ART) and cancer treatment outcomes among people living with HIV (PLWH) in low- and middle-income countries (LMICs) is complex and poorly understood for many cancers. We aimed to summarize existing evidence from LMICs regarding the benefit of ART on cancer treatment-related outcomes.

Recent findings: We included twelve observational studies that reported associations between ART status and cancer treatment outcomes among HIV-positive patients in LMICs. Most confirmed ART was associated with improved cancer treatment outcomes. Heterogeneity in cancers under study, outcome measurement, categorization of ART status, and reporting of HIV-related immune function made formal comparison between studies untenable. Where evaluated, ART generally has a positive effect on cancer outcomes in people with HIV in LMICs. However, there remains a substantial gap in the literature regarding the impact of ART on treatment outcomes for most cancer types. Future research should focus on the optimal timing and integration of ART and cancer treatment for PLWH with strategies applicable to constrained-resource settings.

Keywords: Antiretroviral therapy; Cancer; HIV; LMIC; Treatment outcomes.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • Developing Countries
  • HIV Infections* / drug therapy
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / epidemiology
  • Poverty
  • Treatment Outcome

Substances

  • Anti-HIV Agents