The Use of Antiretroviral Therapy in Patients Undergoing Treatment for Hiv-Related Neoplastic Disease (Clinical Considerations‪)‬

Introduction Individuals with HIV infection and cancer are faced with two complex life-threatening diseases. Treatment of such complex illnesses is more straight-forward for the clinician when adequate evidence-based clinical guidelines are available. However, for many patients with AIDS-related (or "AIDS-defining") malignancies, there are no such guidelines and there is in fact little actual clinical science upon which to base dogmatic recommendations. Several important issues remain inadequately studied in this population. Two such issues are whether or not anti-HIV therapy should be administered during anti-neoplastic therapy, and whether anti-neoplastic chemotherapy should be dose-reduced in the setting of HIV-infection. A one-size fits all solution to this dilemma will neither serve the patient well nor promote clinical studies that will be useful in defining the issues. In the absence of evidence-based medicine, various disease elements and biologic principles must be carefully weighed in terms of the realistic therapeutic goals relevant to the affected individual. In this article, we will focus on the first of these issues--the use of HAART during the treatment of AIDS-related malignancies.