HIV Management Guide for Clinical Care and ARV Guidelines

HIV Management Guide for Clinical Care and ARV Guidelines

HIV-infectious Disease & Cancer

Management

Identification and cessation of the causative medication is paramount. High dose corticosteroids, eg prednisolone 1mg/kg/day are the cornerstone of treatment. This is usually tapered over a period of 6-12 weeks. Guidelines do not suggest differing treatment for DRESS in PLWHIV. Following the acute phase, DRESS patients are at risk of autoimmune sequelae such as diabetes …

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References

Deeks SG, Overbaugh J, Phillips A, Buchbinder S. HIV infection. Nature reviews Disease primers. 2015;1(1):1-22. Hogan MT. Cutaneous infections associated with HIV/AIDS. Dermatologic clinics. 2006;24(4):473-95. Veenstra J, Krol A, van Praag RME, Frissen PMJ, Schellekens PTA, Lange JMA, et al. Herpes zoster, immunological deterioration and disease progression in HIV-1 infection. Aids. 1995;9(10):1153-8. Strick LB, Wald …

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Human papillomavirus infection and associated malignancies in HIV-infected people

Jason Ong1,2, Jenny McCloskey2, Winnie Tong3 1.Central Clinical School, Monash University Department of Clinical Research, London School of Hygiene and Tropical Medicine Sexual Health Clinic, Royal Perth Hospital, Perth, WA Department of Clinical Immunology, St Vincent’s Hospital, Sydney, NSW Last reviewed: November 2019 Introduction The human papillomavirus (HPV) is a DNA virus from the papillomavirus …

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Cervical cancer

Cervical cancer is the 14th most commonly diagnosed cancer among women in Australia with an age standardised incidence rate of 6.8/100,000 in 2013 (5, 6). Almost all (99.7%) cervical cancers have HPV detected in biopsy specimens (7). Cervical cancer incidence starts to rise in women in their late 20s with 30% of cases occurring in …

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Anal cancer

The below information may be outdated, please refer to the latest Anal Cancer Screening Guidelines for People Living with HIV. Anal cancer is defined as a cancer arising either from the squamous or glandular epithelium of the anus.  The vast majority are SCCs (36), with the remainder coded as adenocarcinomas, neuroendocrine neoplasm, malignant melanoma, mesenchymal …

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Oropharyngeal cancer

Oropharyngeal cancer (OPC) is one of the most common head and neck squamous cell carcinomas globally (84). OPC includes cancer of the tonsils, tonsillar crypt and pillars, base of tongue and oropharynx. Traditional risk factors are smoking and excessive alcohol use (85) but in the past two decades, there is a rise in HPV-associated OPC …

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Vulval cancer

Squamous cell carcinoma of the vulva (VSCC) is a rare cancer. Some are associated with HPV-related precursor lesions (vulval intraepithelial neoplasia usual type) especially those associated with HPV 16 (99). However, most cancers are not related to HPV infection. For instance, lichen sclerosus is a non-HPV related skin condition with an increased risk of development …

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Vaginal cancer

Vaginal cancer is extremely rare and is usually related to HPV infection (103), but may rarely be caused by melanoma, sarcoma or adenocarcinoma or be due to metastatic disease.  It occurs mainly in older women and the risk is increased if there have been other HPV-related genital cancers.  Screening There are no recommendations regarding screening …

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Penile cancer

Penile cancers are rare but have significant morbidity and mortality when detected in late stages. Squamous cell cancers cause over 90% of penile cancers and may be related to HPV infection or to phimosis and/or penile chronic inflammation. Incidence in the US is 0.7 per 100,000 men (106) and 0.8 per 100,000 men in Australia …

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The role of vaccination in preventing HPV-associated malignancies

Prophylactic vaccination against HPV has been publicly funded in Australia since 2007 and three HPV vaccines are currently registered for use (Table 1). Since early 2018, the 9-valent HPV vaccine (Gardasil®9, Seqirus/Merck & Co) has been available on the National Immunisation Program (NIP) for all 9-14 year olds using a two dose schedule. For immunocompromised …

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