BackgroundNon-AIDS defining cancers (NADCs) have been an increasing cause of morbidity and mortality in patients with HIV. There is no data on the spectrum of NADCs in Mexico. We describe the type of neoplasms, clinical characteristics, and outcomes of HIV-infected patients with NADCs.MethodsWe conducted a retrospective study of all patients with confirmed diagnosis of NADC attending the HIV/AIDS clinic at the National Cancer Institute in Mexico City (a tertiary-care center for adult patients with cancer) from January 1990 to December 2016.ResultsFrom 1126 HIV-positive individuals seen at the institute since 1990, 127 (11.3%) were diagnosed with NADCs; seven patients developed two NADCs during their follow-up. At diagnosis of NADC median age was 43.7 ± 10.9 years; 101 (79.5%) were male; median CD4 was 273 cells/mm3, 70 patients had a CD4 count of > 200 cells/mm3, 73 had undetectable HIV viral load and 82 had taken combined antiretroviral therapy (cART) for more than 1 year. The most frequent NADCs were in men, Hodgkin lymphoma (34.3%) followed by anal cancer (15.7%), whereas in women, were vulvo-vaginal cancers associated to human papilloma virus (HPV) (51.8%), followed by breast cancer (25.9%). The main risk factor associated with death was cancer progression or relapse (OR, 28.2, 2.5–317.1; p = 0.007).ConclusionsHL- and HPV-related neoplasms are the commonest NADC in a cancer referral hospital from a middle-income country with universal access to cART since year 2005. Screening for early anogenital lesions should be emphasized in patients with HIV. It is essential to establish multidisciplinary groups involving Hemato-oncologists, Oncologists, Gynecologists, and HIV Specialists in the treatment of these patients.
Background Non-AIDS Defining Cancers (NADCs) have been recognized as an increasing cause of morbidity and mortality in HIV patients, related mainly to co-infections and/or lifestyle risks. There is no data of NADCs prevalence in Mexico. We describe type of NADCS, clinical characteristics and outcomes of HIV-infected individuals with NADCs.Methods We conducted a retrospective study of 1126 patients attending the HIV/AIDS Clinic at Instituto Nacional de Cancerología in Mexico city (a tertiary care center for adult patients with cancer), since 1996 to December 2016, who had confirmed NADCs after HIV diagnosis. Demographic and clinical data were collected for all HIV patients with NADCs.ResultsOver 1126 HIV-positive individuals seen at the INCan, 139 (12.3%) patients developed a NADC, five patients developed two NADCs during their follow-up, 114 (82%) were male. The median age at diagnosis of NADCs was 42.4 ± 10.9 years, the median of CD4 was 354.4 cell/mm at that time of NADCs, 81 of them (56.3%) had a CD4 count >200 cell/mm3, 81 (56.3%) had undetectable HIV viral load. In males the distribution of NADCS was 36 (25%) Hodgkin’s lymphoma (HL), 16 (11.1%) anal cancer, 13 (9%) germinal tumors males, and two lung cancers, and in females: 11 (7.7%) vulvo-vaginal, seven (4.9%) breast cancer, four (2.8%) thyroid cancer and one case of Hodgkin’s lymphoma. The median of follow-up of NADCs was 2.5 (IQR 0.4,3.6) years. Nine patients died attributable to NADCs and 51 patients lost of follow-up.Conclusion HL was the most frequent NADC on men as it has been described in other reports, followed by anal cancer. In women vulvo-vaginal cancers were the most frequent. These three malignances are related with viral etiology. Lung cancer was uncommon, different from that described in the US population, smoking is less frequent in the HIV Mexican population. NADCS can occur at any stage of HIV infection, regardless of immune status.Disclosures All authors: No reported disclosures.
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