Book Review

AIDS-Associated Viral Oncogenesis

N Engl J Med 2008; 358:98January 3, 2008

Article

AIDS-Associated Viral Oncogenesis
(Cancer Treatment and Research. Vol. 133.) Edited by Craig Meyers. 270 pp., illustrated. New York, Springer, 2007. $149. ISBN: 978-0-387-46804-4

Almost a quarter of a century has passed since the human immunodeficiency virus (HIV) was identified, and from the outset one of the keys to recognition of the epidemic was the identification of Kaposi's sarcoma as a defining condition of AIDS. The effect of this disease worldwide has been staggering, particularly in sub-Saharan Africa, but a by-product has been considerable insight into the role of the immune system in the neoplastic process and into the role of oncogenic viruses — particularly Kaposi's sarcoma–associated herpesvirus and Epstein–Barr virus (EBV), but also human papillomavirus, hepatitis B virus (HBV), and hepatitis C virus (HCV). The availability of a summary of this research and its clinical applications in a slim and eminently readable volume is therefore welcome, particularly as it relates to Kaposi's sarcoma, lymphoma, squamous-cell neoplasia, and genital dysplasia.

The first chapter of the book is an insightful introduction to the topic. Unfortunately, in the subsequent chapters on malignant conditions associated with AIDS, there is undue redundancy that could have been avoided with more vigilant editing. The discussions of human papillomavirus–related carcinoma of the cervix in women and of the anus in homosexual men before and after the era of highly active antiretroviral therapy are useful reviews of data that are not readily available in summary form. The discussion of the molecular biology of Kaposi's sarcoma–associated herpes virus in relation to AIDS-associated oncogenesis is presented in an appealing and understandable fashion with a comprehensive list of references. The section on EBV is another highlight, with an excellent and well-illustrated summary of the molecular biology of the virus in relation to AIDS-associated oncogenesis. This discussion is followed by a brief review of malignant conditions that are associated with EBV. The chapter on polyomavirus SV40 provides interesting information on virology, but its authors go too far in their attempt to make a connection between SV40 and lymphoma. The brief final chapter on chronic hepatitis viruses (HBV and HCV) is also a creditable summary of current knowledge on the subject.

Although one would like to applaud a concise volume with a mine of useful information on an important and highly relevant topic, the overall effect of this book is marred by redundancy and some idiosyncratic viewpoints by individual authors. Nevertheless, the topic is fascinating, and I found myself turning the pages with increasing excitement as the story of viruses and cancer unfolded.

Jonathan Said, M.D.
David Geffen School of Medicine at UCLA, Los Angeles, CA 90095