AIIMS Raipur NO - 201…: Which is the most common HIV related malignancy?

AIIMS Raipur NO - 2019 (Shift-1)

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Raipur NO - 2019 (Shift-1)

Explanation

Kaposi's sarcoma (KS) is the most common neoplastic disease in individuals with AIDS and is considered an AIDS-defining condition.
It is a cancer that forms in the lining of blood and lymph vessels, caused by the Human Herpesvirus-8 (HHV-8).
Clinically, it presents as painless, reddish-purple to brown-black lesions on the skin, mucous membranes (like the mouth), and can also affect internal organs such as the lungs and gastrointestinal tract.
Although the incidence of KS has markedly decreased since the introduction of potent antiretroviral therapy (ART), it is historically the most frequent malignancy associated with HIV.

Option A: Neuroblastoma is a cancer of immature nerve cells that almost exclusively affects infants and young children. It has no established association with HIV infection.
Option B: The term 'Cell Lymphoma' is vague but likely refers to Non-Hodgkin's Lymphoma (NHL). While aggressive B-cell NHLs are the second most common malignancy in people with HIV, Kaposi's sarcoma is historically and overall considered the most common.
Option C: While the incidence of Hodgkin's Lymphoma is increased in people with HIV compared to the general population, it is significantly less common than both Kaposi's sarcoma and Non-Hodgkin's lymphoma.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Most common malignancy associated with Human Immunodeficiency Virus (HIV) infection as background academic context rather than a clinical decision trigger.
Nurses play a vital role in conducting thorough skin assessments for immunocompromised patients, as early identification of lesions suspicious for Kaposi's sarcoma is crucial for timely diagnosis and management.
The presence of an AIDS-defining illness like Kaposi's sarcoma signifies severe immunodeficiency, typically a CD4+ T cell count below 200 cells/μL, underscoring the need for initiating or optimizing antiretroviral therapy.
Patient education on strict adherence to ART is a key nursing intervention. Effective viral suppression can prevent the development of KS and may even cause existing lesions to regress.

How to Approach the Question

First, identify the key terms in the question: 'most common', 'HIV', and 'malignancy'. This is a factual recall question asking for the most frequent cancer associated with HIV.
Recall the major AIDS-defining illnesses. These include specific opportunistic infections and certain cancers.
Evaluate each option based on its known association with HIV.
Eliminate Neuroblastoma, as it is a pediatric cancer not linked to HIV.
Consider the lymphomas. Both Hodgkin's and Non-Hodgkin's Lymphoma (NHL) are more common in HIV, but NHL is far more prevalent than Hodgkin's.
Compare the top contenders: Kaposi's sarcoma and Non-Hodgkin's Lymphoma. Historically and for examination purposes, Kaposi's sarcoma is cited as the most common malignancy, even though its incidence has fallen with effective treatment.

Concept Tested & Keywords

Concept Tested: Most common malignancy associated with Human Immunodeficiency Virus (HIV) infection.
Stem keywords: HIV, malignancy, most common
Lead-in keywords: Which is
Negative lead-in flag: false

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E6 Medicine Harrison 22e Part 1 pp. 1652-1654, 1654-1656