Despite the impact of combined antiretroviral
therapy (cART) on human immunodeficiency virus (HIV)-related mortality,
malignancies remain the second most common cause of death in
HIV infection in developed countries. In addition to the
AIDS-defining
malignancies, other
cancers such as
Hodgkin's lymphoma and
anal cancer, are more frequent in HIV-infected patients who survive longer even though they do not have complete immune restoration The use of concomitant
antineoplastic chemotherapy and cART have been demonstrated to be feasible and effective in patients with HIV-related
malignancies; however, many drugs used in cART regimens have the potential for causing drug interactions as a result of their ability to either inhibit or induce the
cytochrome P450 (CYP)
enzyme system. Since many
antineoplastic drugs are also metabolised by the CYP system, co-administration with cART could result in either
drug accumulation and possible toxicity, or rapid
drug metabolism and decreased efficacy. Unfortunately, very limited prospective interaction data are available to safely guide the combined use of cART and
chemotherapy. This paper reviews the potential drug interactions and therapeutic considerations of the
antiretroviral agents used to treat HIV and the most common
anticancer agents used in the treatment of
malignancies found in patients with
HIV infection.