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HIV-associated malignancies

Key sources
The following summarized guidelines for the evaluation and management of HIV-associated malignancies are prepared by our editorial team based on guidelines from the British HIV Association (BHIVA 2014).


1.Diagnostic investigations

Evaluation for Kaposi sarcoma
Confirm Kaposi sarcoma histologically.
Consider avoiding routine CT scans, bronchoscopy or gastrointestinal endoscopy in the absence of symptoms.
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  • Evaluation for Castleman's disease

  • Evaluation for anal cancer

2.Medical management

Highly active antiretroviral therapy: initiate HAART in all patients diagnosed with Kaposi sarcoma.

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  • Irradiation of blood products

3.Specific circumstances

Patients with Kaposi's sarcoma: initiate chemotherapy along with HAART for patients with T1 advanced stage Kaposi's sarcoma.
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  • Patients with Hodgkin's lymphoma

  • Patients with diffuse large-B cell lymphoma

  • Patients with Burkitt's lymphoma

  • Patients with multicentric Castleman's disease

  • Patients with primary CNS lymphoma

  • Patients with primary effusion lymphoma

  • Patients with plasmablastic lymphoma

  • Patients with relapsed/refractory aggressive lymphoma

  • Patients with anal cancer

  • Patients with CIN and cervical cancer

  • Patients with non-AIDS-defining malignancies

4.Preventative measures

Provide influenza immunization to all patients with HIV-associated malignancies on an annual basis.
Provide pneumococcal immunization and HBV immunization.

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  • Prophylaxis against opportunistic infections

5.Follow-up and surveillance

Indications for referral to specialized centers: refer all patients with HIV and malignancy to centers that have developed expertise in the management of these diseases.

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  • Consideration for enrollment in clinical trials

  • Monitoring for patients with Hodgkin's lymphoma

  • Monitoring for patients with multicentric Castleman's disease