US Pharm. 2007;32(9):HS-40.

Many Cancers Signal HIV/AIDS
More infection-related cancers result from immunodeficiencies than previously thought, according to a meta-analysis reported in Lancet. Researchers found that the incidence of 20 out of 28 malignancies, most known to be caused by infection, were significantly greater among AIDS or HIV patients and patients with solid organ transplants, reported Andrew E. Grulich, PhD, of the University of New South Wales, and colleagues. Until now, only Kaposi's sarcoma, non-Hodgkin's lymphoma, and cervical cancer were viewed as AIDS-identifying illnesses.

The study included 444,172 patients with HIV/AIDS in the U.S., Europe, and Australia and 31,977 organ-transplant recipients in Europe, Australia, and Canada. Other cancer types with higher incidences in HIV/AIDS patients included stomach, liver, cervix uteri, vulva and vagina, penis, oral cavity, and pharynx. "The range of infection-related cancers associated with immune deficiency is much wider than previously appreciated and a range of infectious organism seems to be implicated," said Dr. Grulich.

MRI for Breast Cancer
MRI screenings detected more breast cancers than either mammography or ultrasounds in high-risk women; however, the method also produced nearly four times the biopsy rate according to researchers at the University of Washington. The study, reported in Radiology, compared the three screening modalities in 171 asymptomatic women who carried the BRCA1 and/or BRA2 mutation or had at least a 20% chance of carrying the mutation. All six cancers that were detected in 16 biopsies were found using MRI; two were detected using mammography, and one cancer was found using ultrasound.

The study supports MRI "as an important complement to manmography in screening women at high risk for breast cancer," said the researchers. They acknowledged, however, that their study was small and did not include long-term follow-up. 

Abstinence Programs Alone Are Ineffective
Paralleling the findings of earlier studies in developing regions, a review of clinical trials in the U.S. found that abstinence-only programs to prevent HIV and pregnancy in high-income countries are ineffective. Control groups in the trials, which enrolled nearly 16,000 youths, included safer sex counseling, no treatment, time-matched abstinence-plus programs, and abstinence programs without enhancements.

"When compared to a variety of control groups, the participants in these 13 abstinence-only program trials did not report differences in risky sexual behaviors or biological outcomes," researchers at the University of Oxford's Centre for Evidenced-Based Intervention said.   

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