A Global Focus: the Connection Between HIV/AIDS and Kaposi Sarcoma

Louisiana is ranked 3rd in the US in estimated case rates of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The South as a whole makes up more than half of new HIV infections in the US. Across the Atlantic, sub-Saharan Africa faces the greatest burden from HIV/AIDS, making up 67% of the nearly 40 million people living with HIV globally.

Around the world, HIV/AIDS takes a significant toll on people living with it. It puts the same population at a greater risk of developing cancer, such as Kaposi Sarcoma (KS).

At LSU LCMC Health Cancer Center, this connection between AIDS and KS is the driving force behind our global research. By working with two populations who share similar risk factors, challenges, and outcomes, we can further understand how to relieve the burden of cancer worldwide. 

How Can HIV/AIDS Lead to Kaposi Sarcoma?

HIV is a virus that targets the body’s immune system, which fights infections and diseases, such as cancer. Someone who is infected with HIV (called HIV-positive) does not necessarily have AIDS. A person is considered to have AIDS when the virus has caused enough damage to the immune system to allow them to get certain kinds of infections, including KS. 

KS, which is found in the lining of lymph and blood vessels, is caused by an infection with the human herpesvirus 8 (HHV-8) – also known as the Kaposi sarcoma-associated herpesvirus (KSHV). In healthy people, infection with HHV-8 doesn’t usually cause symptoms, as the immune system can fight it. But in people with a weakened immune system, such as those living with HIV/AIDS, it can lead to KS. 

KS shows up in patches (called lesions) on soft tissues, such as the skin, lymph nodes, or organs, and can be pink, purple, red, or brown. It becomes life-threatening if it spreads to the throat or lungs.

Cancers like KS are more common in those with HIV/AIDS because: 

• People with HIV/AIDS have a weaker immune system, making them more susceptible to cancer. 
• HIV supports the growth of other viruses. HIV and other viruses promote the growth of cancer cells, making cancer advance more quickly compared to people without HIV. In the case of KS, HIV works with HHV-8 to support the growth of cancer. 
• Medications for HIV/AIDS are helping people live longer. However, their immune systems don’t fully regain their strength. As people living with HIV/AIDS get older, their risk of other health problems, including cancer, increases. 

HIV/AIDS and Other Cancers

In addition to KS, people living with HIV/AIDS are more likely to develop other cancers, including: 

• Non-Hodgkin's lymphoma, which typically starts in the lymph glands (a part of the immune system). These glands are in the neck, groin, under the arms, and inside the belly. 
• Cervical cancer (in women), which develops in the cervix (the area from the entrance of the vagina to the uterus). 

Because people living with HIV have compromised immune systems, they are also at risk of non-AIDS-related cancers, including Hodgkin’s lymphoma, lung cancer, anal cancer, liver cancer, and other cancers.

The Impact of Studying KS and Other Cancers on a Global Scale 

Global oncology research highlights the widespread and indiscriminate nature of cancer. It can affect anyone, no matter where they call home. Still, the high rates of HIV in both Louisiana and sub-Saharan Africa put these populations at a higher likelihood of developing cancer, including KS. 

On its own, this similarity offers extensive research opportunities to help diagnose and treat KS. More patients, researchers, and resources allow for a greater understanding of HIV/AIDS, KS, and the connection between the two. Research in one location benefits patient care in another, making this exchange of knowledge not just beneficial for science, but life-changing for those affected by cancer wherever they call home. 

This correlation goes beyond the incidence rate of these diseases. Some populations in Louisiana and Africa also share other risk factors in developing cancer and diagnosing it at later stages, when it’s more difficult to treat, including: 

• Limited or no access to care, such as from inadequate health insurance or lack of nearby providers 
• Low cancer screening rates 
• Risky lifestyle choices, such as alcohol use and smoking 
• Obesity 

Both populations are up against a range of challenges. LSU LCMC Health Cancer Center’s Global Oncology efforts provide funding, build infrastructure, and attract passionate and skilled researchers to populations disproportionately affected by cancer. By investing in research in Louisiana and Africa, we can contribute to ongoing and lifesaving research and positively impact the lives of people living with cancer today.