Hiv and Cancer in Adults and Children in Kampala, Uganda.

Newton, Robert; Ziegler, John L.; Beral, Valerie; Mbidde, Edward; Parkin, Max; Carpenter, Lucy; Wabinga, Henry; Mbulataiye, Sam; Appleby, Paul N.; Reeves, Gillian; Garcia-Giannoli, H.; Jaffe, Harold W.

doi:10.1097/00126334-199905010-00021

Cited by 5 publications

(2 citation statements)

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“…For example, in a South African study (13), the relative risk of Kaposi's sarcoma in HIV-infected individuals, compared with HIV-uninfected individuals, was 62 (95% confidence interval [CI] ‫ס‬ 20-194). Although this is similar to results from elsewhere in Africa (14,15), it is an order of magnitude lower than would be expected from studies in, for example, the United States (5). This result simply reflects the fact that Kaposi's sarcoma is endemic in Africa with a relatively high proportion of HIV-uninfected cases; thus, the absolute risk of developing Kaposi's sarcoma among those individuals who are co-infected with HIV and with human herpesvirus 8 (HHV8) is probably about the same as in the United States.…”

Section: Hiv and Kaposi's Sarcomasupporting

confidence: 84%

Kaposi's Sarcoma in South Africa

Sitas

Newton²

2000

JNCI Monographs

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Kaposi's sarcoma was endemic in South Africa even before the advent of the human immunodeficiency virus (HIV). Between 1988 and 1996, the incidence of Kaposi's sarcoma in South Africa has risen at least threefold and continues to increase as the HIV epidemic grows. Research from South Africa has shown that infection with human herpesvirus 8 (HHV8) is associated with Kaposi's sarcoma but not with any other major cancer site or type. In addition, the risk of Kaposi's sarcoma increases with increasing antibody titer to HHV8, but, for a given titer, the risk is greater in HIVseropositive compared with HIV-seronegative individuals. The age-and sex-standardized seroprevalence of HHV8 in black South African hospital patients was found to be slightly more than 30%; the seroprevalence of HHV8 increased with age and was similar in men and in women. The modes of transmission of HHV8 are yet to be fully elucidated. Limited evidence exists for sexual transmission in black South African adults, but mother-to-child and personto-person transmission in childhood is also likely. Furthermore, the seroprevalence of HHV8 decreases with increasing levels of education and is lower in whites than in blacks, suggesting that factors associated with poverty may be important determinants of transmission. Future research should focus on risk factors for Kaposi's sarcoma in HHV8-infected individuals, on determinants and mode of transmission of HHV8, and on the elucidation of the effect of primary

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Section: Hiv and Kaposi's Sarcomasupporting

confidence: 84%

Kaposi's Sarcoma in South Africa

Sitas

Newton²

2000

JNCI Monographs

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“…Therefore, the analyses presented here are restricted to 302 adults (of 1,424) and 318 children (of 1,127) with various cancers and other non‐malignant conditions who were resident in Kampala before becoming ill and for whom HIV status was known. Data that did not take account of the heterogeneity between regions of residence have been presented in a conference abstract and should be discounted 6. Adults with Kaposi's sarcoma were not included in the analyses as these subjects were recruited in a different way and have been reported elsewhere 5…”

Section: Methodsmentioning

confidence: 99%

A case-control study of human immunodeficiency virus infection and cancer in adults and children residing in Kampala, Uganda

Newton¹,

Ziegler

Beral³

et al. 2001

Int. J. Cancer

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122

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Uganda offers a unique setting in which to study the effect of human immunodeficiency virus‐1 (HIV‐1) on cancer. HIV‐1 is prevalent there, and cancers which are known to be HIV‐associated, such as Kaposi's sarcoma and Burkitt's lymphoma, are endemic. Adults residing in Kampala, Uganda, presenting with cancer in city hospitals were interviewed and had an HIV test. Of the 302 adults recruited, 190 had cancers with a potentially infectious aetiology (cases). The remaining 112 adults with tumours not known to have an infectious aetiology formed the control group. In addition, 318 children who were also Kampala residents were recruited and tested for HIV: 128 with cancer (cases) and 190 with non‐malignant conditions (controls). HIV seroprevalence was 24% in adult controls and 6% in childhood controls. The odds of HIV seropositivity among cases with specific cancers (other than Kaposi's sarcoma in adults) were compared with that among controls, using odds ratios (ORs), estimated with unconditional logistic regression. All ORs were adjusted for age (<5, 5–14, 15–19, 30–44, 45+) and sex and, in adults, also for the number of lifetime sexual partners (1 or 2, 3–9, 10+). In adults, HIV infection was associated with a significantly (p < 0.05) increased risk of non‐Hodgkin's lymphoma [OR = 6.2, 95% confidence interval (CI) 1.9–19.9, based on 21 cases] and conjunctival squamous‐cell carcinoma (OR = 10.9, 95% CI 3.1–37.7, based on 22 cases) but not with cancer at other common sites, including liver and uterine cervix. In children, HIV infection was associated with a significantly increased risk of Kaposi's sarcoma (OR = 94.9, 95% CI 28.5–315.3, based on 36 cases) and Burkitt's lymphoma (OR = 7.5, 95% CI 2.8–20.1, based on 33 cases) but not with other cancers. The pattern of HIV‐associated cancers in Uganda is broadly similar to that described elsewhere, but the relative frequency of specific cancers, such as conjunctival carcinoma, in HIV‐infected people differs. © 2001 Wiley‐Liss, Inc.

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