Even with effective ART people with HIV remain at increased risk of many medical comorbidities. Most prominent among these is an elevated risk of cancer. The risk of malignancy remains approximately double that of the general population and, in both resource rich and resource limited settings, cancer is now the leading cause of death for people with HIV. Although cancers associated with severe immunosuppression are less common in the modern era, the risk of many malignancies including most lymphomas, lung cancer, and anal cancer remains substantially elevated as Shiels et al. (pp. 6–11) describe in this issue. This excess burden of cancer is important not only for its human impact on people living with HIV but also for its resource implications for health systems and its social and economic impact on communities.
The 14 reviews in this issue of Current Opinion in HIV and AIDS, entitled ‘Clinical and scientific challenges in HIV-associated malignancies’, are selected to reflect the breadth of clinical science currently underway in HIV-associated malignancies. They are grouped thematically, covering, in the first section epidemiology and the foundational role of ART; in the second, advances in prevention and therapy of specific HIV-associated malignancies; and in the third, broader issues in the field including selected special populations. In this editorial, we discuss the implications of the advances described in this issue as they apply in resource rich and resource limited settings, and consider the ways in which work in HIV-associated malignancies can help inform and develop clinical care and scientific studies more broadly.