Brief Report: Malignancies in Adults Living With HIV in Asia
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS: Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier. RESULTS: Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy. CONCLUSIONS: Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
Authors: Awachana Jiamsakul, Mark Polizzotto, Stephane Wen-Wei Ku, Junko Tanuma, Eugenie Hui, Romanee Chaiwarith, Sasisopin Kiertiburanakul, Anchalee Avihingasanon, Evy Yunihastuti, Nagalingeswaran Kumarasamy, Penh Sun Ly, Sanjay Pujari, Rossana Ditangco, Cuong Duy Do, Tuti Parwati Merati, Pacharee Kantipong, Fujie Zhang, Kinh Van Nguyen, Adeeba Kamarulzaman, Jun Yong Choi, Benedict L.H. Sim, Oon Tek Ng, Jeremy Ross, Wingwai Wong, on behalf of the TREAT Asia HIV Observational Database of IeDEA Asia-Pacific
Institutions: UNSW Sydney, Kirby Institute, Taipei Veterans General Hospital, National Center for Global Health and Medicine, Queen Elizabeth Hospital, Chiang Mai University, Mahidol University, Ramathibodi Hospital, Chulalongkorn University, HIV Netherlands Australia Thailand Research Collaboration, University of Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, YR Gaitonde Centre for AIDS Research and Education, University of Health Science, National Center for HIV/AIDS, Dermatology and STD, Research Institute for Tropical Medicine, Bạch Mai Hospital, Udayana University, ChiangRai Prachanukroh Hospital, Capital Medical University, Beijing Ditan Hospital, Hospital for Tropical Diseases, University Malaya Medical Centre, University of Malaya, Yonsei University, Yonsei University Health System, Hospital Sungai Buloh, Tan Tock Seng Hospital, American Foundation for AIDS Research
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2903885367