According to a recent study from researchers at Columbia University in New York City, the most frequent cause of death in people with human immunodeficiency virus (HIV) is cancer, with B-cell lymphoma being the most commonly occurring type. The report, titled “Malignancies, Particularly B-Cell Lymphomas, Are a Frequent Cause of Mortality in Human Immunodeficiency Virus-1 Patients Despite Highly Active Antiretroviral Therapy“ appeared in the journal Open Forum Infectious Diseases.
High active antiretroviral therapy (HAART) has greatly expanded the life expectancy of people living with HIV infection and greatly reduced deaths due to liver disease and AIDS. However, according to this recent study, people with HIV still have a reduced life span as a consequence of other diseases such as cancer. “Although it remains unclear as to exactly what is driving all the deaths in the HIV-1-infected population, in our [group of study subjects] many HIV-1 patients did not enjoy the full life expectancy seen in their HIV-1-uninfected peers,” the researchers wrote in their report.
Daniel O. Griffin of both the Columbia University Medical Center Department of Medicine-Division of Infectious Disease and Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, led the study, which included 2,000 HIV-1-infected individuals. The researchers tracked patients for 5 years from January 1, 2010 through December 31, 2014, noting all deaths and cause of death during that time period. There was a total of 153 deaths, with 11% of these individuals not taking medication for their HIV. The age of death was typically 52.8 years. Cancer was the most common cause of death, occuring in 39% of the study participants. Other causes included AIDs (20%), liver disease (10%), violence, accidental or suicidal death (9%), coronary artery disease (3%) and renal failure (2%).
Lymphoma was by far the most common cause of cancer mortality, occurring in 34% of all cancer deaths with Burkitt’s lymphoma (non-Hodgkin’s B cell) accounting for the most frequently recorded lymphoma type, followed by other forms of non-Hodgkin’s lymphomas.
In their report the investigators noted “we are currently observing that malignancy is the most significant cause of death. Among these malignancies, B-cell lymphomas are not only the most common but appear to be very aggressive with a median survival of <2 months from the time of diagnosis.” It is possible that treatment of individuals with HIV may shift to address lymphomas, and understanding why these cancers grow could be an additional new focus of future HIV research.