Incidence of <scp>AIDS</scp>‐defining cancers and virus‐related and non‐virus‐related non‐<scp>AIDS</scp>‐defining cancers among <scp>HIV</scp>‐infected patients compared with the general population in a large health district of northern <scp>I</scp>taly, 1999–2009

Calabresi, Alessandra; Ferraresi, Alice; Festa, Andrea; Scarcella, Carmelo; Donato, Francesco; Vassallo, F; Limina, Rm; Castelli, Francesco; Quirós-Roldán, Eugenia

doi:10.1111/hiv.12034

Cited by 69 publications

(50 citation statements)

References 30 publications

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“…In contrast to the decrease seen in US and Europe 10, 11 , we observed a slight increase in NHL incidence with increasing ART availability in Uganda. The majority of NHL cases were endemic Burkitt lymphoma (BL) and account for the low median age of NHL patients in our study population.…”

Section: Discussioncontrasting

confidence: 99%

A Population-Level Evaluation of the Effect of Antiretroviral Therapy on Cancer Incidence in Kyadondo County, Uganda, 1999–2008

Mutyaba

Phipps

Krantz

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background The introduction of antiretroviral therapy (ART) in the US and Europe has led to changes in the incidence of cancers among HIV- infected persons, including dramatic decreases in Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL), and increases in Hodgkin lymphoma (HD), liver and anogenital malignancies. We sought to evaluate whether increasing availability of ART is associated with changing cancer incidence in Uganda. Methods Incident cases of 10 malignancies were identified from Kampala Cancer Registry from 1999 to 2008. ART coverage rates for Uganda were abstracted from UNAIDS reports. Negative binomial and poisson regression modeled the association between ART coverage and age-adjusted cancer incidence. Results ART coverage in Uganda increased from 0 to 43% from 1999 to 2008. With each 10% increase in ART coverage, incidence of Kaposi sarcoma decreased by 5%(incidence rate ratio [IRR]=0·95, 95% CI: 0·91–0·99, P=0·02) and stomach cancer decreased by 13% (IRR=0·87 [0·80–0·95], P=0·002). Conversely, incidence of non-Hodgkin lymphoma increased by 6% (IRR=1·06 [1–1·12], P=0·05), liver cancer by 12% (IRR=1·12 [1·04–1·21], P=0·002), prostate cancer by 5% (IRR=1·05 [1–1·10], P=0·05), and breast cancer by 5% (IRR=1·05 [1–1·11], P=0·05). ART coverage was not associated with incidence of invasive cervical cancer, lung, colon, and Hodgkin disease. These findings were similar when restricted to histologically confirmed cases. Conclusion Our findings suggest that AIDS-defining malignancies and other malignancies are likely to remain significant public health burdens in sub-Saharan Africa even as ART availability increases.

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Section: Discussioncontrasting

confidence: 99%

A Population-Level Evaluation of the Effect of Antiretroviral Therapy on Cancer Incidence in Kyadondo County, Uganda, 1999–2008

Mutyaba

Phipps

Krantz

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…However, while HIV-infected individuals have been shown to have an excess of ADM and NADM, the effect of cumulative HIV on NADM risk has not been adequately evaluated. 14 If associated with NADM risk, cumulative HIV may be a functional instrument to identify high-risk individuals for cancer screening. The aim of our study was to evaluate the association between three different cross-sectional and cumulative HIV measures and virally-associated NADM hazard (i.e., HCC, HL, SCCA; representing the three most prevalent virally-associated NADM 15 ) among US male veterans diagnosed with HIV infection between 1985 and 2010.…”

Section: Introductionmentioning

confidence: 99%

Cumulative HIV Viremia and Non–AIDS-Defining Malignancies Among a Sample of HIV-Infected Male Veterans

Kowalkowski

Day

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction Research suggests cumulative measurement of HIV exposure is associated with mortality, AIDS, and AIDS-defining malignancies. However, the relationship between cumulative HIV and non-AIDS-defining malignancies (NADMs) remains unclear. The aim of this study was to evaluate the effect of different HIV measures on NADM hazard among HIV-infected male veterans. Methods We performed a retrospective cohort study utilizing Veterans Affairs HIV Clinical Case Registry data from 1985-2010. We analyzed the relationship between HIV exposure (recent HIV RNA, % undetectable HIV RNA, and HIV copy-years viremia) and NADM. To evaluate the effect of HIV, we calculated hazard ratios for three common virally-associated NADM (i.e., hepatocarcinoma (HCC), Hodgkin lymphoma (HL), squamous cell carcinoma of the anus (SCCA)) in multivariable Cox regression models. Results Among 31,576 HIV-infected male veterans, 383 HCC, 211 HL, and 373 SCCA cases were identified. In multivariable regression models, cross-sectional HIV measurement was not associated with NADM. However, compared to <20% undetectable HIV, individuals with ≥80% had decreased HL (aHR=0.62; 95%CI=0.37-1.02) and SCCA (aHR=0.64; 95%CI=0.44-0.93). Conversely, each log-10 increase in HIV copy-years was associated with elevated HL (aHR=1.22; 95%CI=1.06-1.40) and SCCA (aHR=1.36; 95%CI=1.21-1.52). Model fit was best with HIV copy-years. Cumulative HIV was not associated with HCC. Conclusion Cumulative HIV was associated with certain virally-associated NADM (i.e., HL, SCCA), independent of measured covariates. Findings underline the importance of early treatment initiation and durable medication adherence to reduce cumulative HIV burden. Future research should prioritize how to best apply cumulative HIV measures in screening for these cancers.

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“…It has been reported that HIV infection may increase the risk of some neoplasms, such as gastric cancer, lung cancer, pancreatic cancer and cloacogenic carcinoma [14]. One case of gastric cancer in our group of patients had been HIV positive for 7 years, and the patient was diagnosed with poorly differentiated adenocarcinoma by endoscopic biopsy.…”

Section: Aids Associated Neoplasmsmentioning

confidence: 65%

“…Kaposi's sarcoma and lymphoma are the most common neoplasms associated with AIDS, which have been recognized as AIDS-defining conditions [14]. Reticuloendothelial cells derived from Kaposi's sarcoma, characterized by abnormal vascular hyperplasia, possibly do damage to the skin and internal organs.…”

Section: Aids Associated Neoplasmsmentioning

confidence: 99%

Diagnostic imaging of gastrointestinal lesions complicating AIDS

Zhang

Zhao

Chen

et al. 2015

Radiology of Infectious Diseases

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Objective: To investigate the findings about gastrointestinal lesions in patients with HIV/AIDS by diagnostic imaging.Methods: The findings about gastrointestinal lesions by diagnostic imaging in 11 patients with HIV/AIDS were retrospectively analyzed. Plain chest radiography was performed for all the 11 cases, but chest CT scanning for 4 cases, abdominal CT scanning for 9 cases, pelvic CT scanning for 2 cases, pelvic MR imaging for 1 case, and gastrointestinal endoscopy for 9 cases. Results: Gastrointestinal perforation was shown in 3 cases, including 2 cases of esophageal perforation and 1 case of gastric perforation. Intestinal tuberculosis was diagnosed in 2 cases, cytomegalovirus enteritis in 1 case, lymphoma in 4 cases, and gastric adenocarcinoma in 1 case. Esophageal perforation was shown together with mediastinal esophageal fistula, mediastinal lymph nodes tuberculosis and pulmonary tuberculosis. Gastric perforation was shown with gastric fistula, left lobe hepatic abscess and hepatogastric space abscess. Intestinal tuberculosis was shown with thickened ileocecal wall, while cytomegalovirus colitis was indicated by central thickening of rectum wall and the end-piece of sigmoid colon. Lymphoma was indicated by tumor-like thickening of gastrointestinal wall, luminal stenosis or dilatation, with accompanying ulceration and enlarged peripheral lymph nodes. Gastric adenocarcinoma was demonstrated with thickening and stiffness of gastric wall, with significant enhancement by contrast imaging/scanning. Conclusion: Gastrointestinal lesions in patients with HIV/AIDS may indicate a variety of opportunistic infections and malignancies, and radiological modalities contribute to the diagnosis of these lesions.

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Incidence of AIDS‐defining cancers and virus‐related and non‐virus‐related non‐AIDS‐defining cancers among HIV‐infected patients compared with the general population in a large health district of northern Italy, 1999–2009

Cited by 69 publications

References 30 publications

A Population-Level Evaluation of the Effect of Antiretroviral Therapy on Cancer Incidence in Kyadondo County, Uganda, 1999–2008

A Population-Level Evaluation of the Effect of Antiretroviral Therapy on Cancer Incidence in Kyadondo County, Uganda, 1999–2008

Cumulative HIV Viremia and Non–AIDS-Defining Malignancies Among a Sample of HIV-Infected Male Veterans

Diagnostic imaging of gastrointestinal lesions complicating AIDS

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