From the Guidelines
Antiviral medication for Human Immunodeficiency Virus (HIV) does not cause dendritic cell neoplasm. The current evidence, as outlined in the 2018 guidelines from the National Comprehensive Cancer Network [ 1 ], emphasizes the importance of managing HIV in patients with cancer, focusing on potential drug-drug interactions and the selection of antiretroviral therapies (ART) that are safe to use alongside cancer therapies. Key points to consider include:
- The selection of ART should be done carefully to avoid drug-drug interactions, especially with regimens containing pharmacologic boosters like ritonavir and cobicistat, which can inhibit CYP3A/4 and interact with agents metabolized by that pathway [ 1 ].
- Integrase inhibitors without pharmacologic boosters are favored in the setting of malignancy due to a lower potential for drug-drug interactions [ 1 ].
- Effective HIV treatment with antiretroviral therapy reduces the risk of certain cancers associated with HIV infection by restoring immune function [ 1 ].
- There is no established evidence linking antiviral medications for HIV to the causation of dendritic cell neoplasms; instead, the focus is on managing HIV to prevent immune suppression, which can increase cancer risk [ 1 ]. It is crucial for patients to discuss any concerns about medication side effects with their healthcare provider rather than discontinuing prescribed HIV treatment, as proper management of HIV is key to reducing the risk of associated cancers and other complications [ 1 ].
From the Research
Antiviral Medication for HIV and Dendritic Cell Neoplasm
There is no direct evidence in the provided studies to suggest that antiviral medication for Human Immunodeficiency Virus (HIV) causes dendritic cell neoplasm.
Adverse Effects of Antiviral Medications
- The studies compare the efficacy and safety of different antiviral regimens, including tenofovir DF, emtricitabine, efavirenz, zidovudine, lamivudine, abacavir, and dolutegravir 2, 3, 4, 5, 6.
- Adverse effects mentioned in the studies include haematological effects (anaemia, leukopenia), lipoatrophy, renal disorders (tubulopathy, Fanconi syndrome), bone disorders (osteoporosis, fractures, osteomalacia), gastrointestinal disorders, hypersensitivity reactions, and cardiovascular events 4, 5, 6.
- However, none of the studies mention dendritic cell neoplasm as an adverse effect of antiviral medication.
Efficacy of Antiviral Regimens
- The studies demonstrate the efficacy of different antiviral regimens in suppressing HIV-1 RNA levels and increasing CD4 cell counts 2, 3, 5, 6.
- The regimens compared include tenofovir DF, emtricitabine, and efavirenz; zidovudine, lamivudine, and efavirenz; abacavir, dolutegravir, and lamivudine; and tenofovir alafenamide, emtricitabine, and various third drugs 2, 3, 5, 6.
- The studies show that these regimens are effective in maintaining virological suppression and improving CD4 cell counts, but do not provide evidence on the development of dendritic cell neoplasm.