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HIV and prostate cancer/inflammation: a systematic review of the literature
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This question is among the many that is included in an aging discussion, but clearly we are NOT having a large and defining aging discussion among the community of researchers and institutions like the NIH that run and fund HIV research. It is hard to believe that all these clearly important aging-related issues are not getting higher profile attention and discussion. Clearly we don't know if prostate cancer risk is higher in HIV and it appears that screening is not adequate in part because of a lack of discussion by the research community & the NIH about prostate AND other aging issues. Of course the European as well as the USA research communities bear the burden for not promoting discussion, as well as in Australia and Canada to. Frankly, I think its a bit shameful.
Increased Prostate Cancer Incidence in Aging Population HIV+
a VA prospective study presented at CROI 2007 of 3000 patients followed since 1982 found increase incidence of prostate cancer after 2003 leading the authors to conclude: The incidence of prostate cancer has increased dramatically in this aging cohort of HIV infected patients.
HIV+ individuals should be getting screened regularly perhaps earlier than HIV- individuals but studies suggest HIV+ individuals are NOT getting screened.
Several non-AIDS-defining malignancies have emerged as significant problems, but there are few data about the incidence of prostate cancer or guidelines for ...
www.natap.org/2007/CROI/croi_67.htm
But a systemic review of the literature was unable to find a higher prevalence of prostate cancer among HIV+ although the authors say the studies conducted are not adequately designed to answer the question.
HIV and prostate cancer: a systematic review of the literature
Although a study reported below found the prostate to be a reservoir for HIV and that immunosuppression and immune dysregulation might predispose an HIV+ man to prostate cancer the finding of this large study is that they did not find a higher prevalence of prostate cancer in men, a review of the literature found however mixed results leading authors to say proper studies probably have not been conducted to provide a good answer to this question. HOWEVER, a VA prospective study presented at CROI 2007 of 3000 patients followed since 1982 found increase incidence of prostate cancer after 2003 leading the authors to conclude: The incidence of prostate cancer has increased dramatically in this aging cohort of HIV infected patients. Prostate cancer should be added to the malignancies now being seen in HIV-infected patients. The known risk factors of age and race appear to remain the same regardless of HIV status.
The true incidence of prostate cancer in this population is unknown. In the few cases that have been presented in the literature, prostate cancer in ...
www.natap.org/2008/HIV/090808_01.htm
Prostate Cancer and Prostatic Diseases advance online publication 19 August 2008
"Interestingly HIV protease inhibitors have been demonstrated to decrease proliferation of PCa cells via inhibition of nuclear factor-B"
"Conclusion: Patients with HIV are living longer in large part because of new innovations of viral treatment. As this trend continues, these patients are at risk of secondary malignancies. The incidence of PCa may theoretically be increased in HIV-positive patients because of immunosupression and because other tumors occur with increased frequency. There is mixed evidence of a relationship between HIV and PCa incidence. Some have suggested that HIV-positive cohorts are inadequately screened for PCa, but in the few prospective screening studies a higher prevalence of PCa has not been detected. The HIV-positive men who are diagnosed with PCa often have tumors and demographics that are not dissimilar to age-matched cohorts. The life expectancy of modern HIV-positive men warrants consideration for treatment for PCa similar to age- and comorbidity-matched men. Although there are limited data on outcomes, HIV-positive men do appear to tolerate surgical or radiotherapeutic interventions with little increased morbidity. Future studies should be aimed at using age-appropriate PSA screening and characterizing long-term outcomes of this patient population."
"Based on these and several other large retrospective population-based studies, it is difficult to determine if there is an increased or decreased incidence of HIV in an age-matched general population.25, 26 These observation-based, epidemiologic studies simply look at incidence of PCa in an HIV-positive cohort which is dependent on detection and, thus, PSA and DRE screening. It has been hypothesized that reports of lower incidence of PCa in HIV positive individuals may be due to decreased screening of this group.16, 23"
"Testosterone: Hypogonadism is more prevalent in the HIV-positive population, with prevalence rates about 20% higher than age-matched controls.37 The etiology of this hypogonadism is unclear but may be related to a combination of factors, including HIV, HAART, malnutrition and opportunistic infections. Hypogonadism may result in or contribute to reduced bone mineral density and muscle mass, poor mood, anemia, decreased libido and erectile dysfunction. Testosterone replacement therapy helps improve these conditions and is often prescribed for hypogonadal men with HIV. Testosterone replacement has been linked, albeit not definitely, to an increased risk of development of PCa. Although it is universally agreed that men with elevated PSA or abnormal DRE findings should undergo a prostate biopsy before initiating testosterone replacement therapy, there is no generally agreed upon monitoring regimen for PCa in patients with normal PSA and DRE findings. Some authors advocate a prostate biopsy before initiating testosterone replacement therapy even in men with normal DRE results and PSA levels.38 This is a particularly important and difficult issue in the HIV-positive population because the incidence and relationship between PCa and HIV are unclear. There are very limited data on this topic but Pantanowitz et al.10 reported that in their series of 13 men with a known diagnosis of HIV before a diagnosis of PCa, 3 had received testosterone therapy. If HIV truly does represent a risk for PCa, then more rigorous screening may be necessary in this group as a whole, and especially in those on testosterone replacement therapy. At this point in time no definitive recommendations can be offered but it should be noted that many men with HIV are receiving testosterone replacement and are not adequately being screened."
Heavy Multivitamin Use May Be Linked to Advanced ProstateCancer
In this large prospective study, we found that multivitamin use was unrelated to overall risk of total and organ-confined prostate cancer. ...
www.natap.org/2007/HIV/052207_09.htm
Broccoli Consumption May Prevent or Reduce Risk of Prostate Cancer
In conclusion, we consider that our study has provided a mechanistic basis for the reduction in risk of prostate cancer through broccoli consumption, ...
www.natap.org/2008/newsUpdates/071708_01.htm
prostate is a reservoir for HIV.
Persistent and Pesky: residual replicating HIV and latent ...
Persistent and Pesky: residual replicating HIV and latent reservoirs including genital secretions. Written by David Margolis, MD, University of Texas, Southwestern Medical Center
Male genital secretions are a complex mixture of cells and secretions from the testes, epidydimis, vas deferens, seminal vesicles, prostate, urethral, ...
www.natap.org/2003/Retro/day7.htm
The author's conclude these data suggest that the prostate is a reservoir for HIV. This has significant transmission consequences, as prostate massage resembles receptive anal intercourse in men who have sex with men. prostate stimulation via anal intercourse could therefore increase the amount of HIV RNA in the receptive partner'' genital secretions, which could then be transmitted when he becamethe insertive partner. These data could, in part, explain the high HIV infection rates historically seen in men who have sex with men. (abs 459a, "The prostate as a Reservoir for HIV-1", Smith, Kingery, Ignacio, Wong, Richman, Little, Univ of California, San Diego and Loma Linda Univ, CA)
More on Viral Reservoirs and Transmission
Since the prostate can harbor bacterial and fungal infections, ... Samples from weeks 1-4 and 11 were collected without prior prostate massage (PM), ...
www.natap.org/2003/Retro/day6.htm
Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and ...
Feb 23, 2009 ... Despite the existence of plausible biologic mechanisms, the effects of dairy food and calcium intakes on prostate cancer are unclear. ...
www.natap.org/2009/HIV/022709_05.htm
Progenics Pharmaceuticals' HIV Drug, PRO 140, Receives FDA Fast...
Feb 22, 2006 ... In collaboration with Cytogen Corporation, the Company is developing immunotherapies for prostate cancer, including a human monoclonal ...
www.natap.org/2006/HIV/022406_02.htm
Abnormal Glucose is a Risk Factor for Cancer
After exclusion of prostate cancer, the association between glucose levels .....However, for prostate cancer, which accounted for more than two-thirds of ...
www.natap.org/2007/HIV/040507_04.htm
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