Spectrum of AIDS defining &amp; non-AIDS defining malignancies in north India

Sachdeva, Ravinder Kaur; Sharma, Aman; Singh, Surjit; Varma, Subhash

doi:10.4103/0971-5916.191813

Cited by 9 publications

(14 citation statements)

References 28 publications

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“…KS incidence is geographically variable, and depends on the prevalence of human herpesvirus-8 infection, the prevalence of HIV, and access to HIV treatment [ 38 , 39 ]. Our findings are consistent with other studies where ADC were still the most frequent malignancies observed, even in more recent years of the epidemic [ 20 , 21 , 40 – 42 ]. However, many recent reports describe an increasing proportion of cancers due to NADC, and occurring more frequently than ADC, among HIV cohorts [ 24 , 43 – 48 ].…”

Section: Discussionsupporting

confidence: 94%

Survival after cancer diagnosis in a cohort of HIV-positive individuals in Latin America

Fink

Jenkins

Castilho

et al. 2018

Infect Agents Cancer

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BackgroundThis study aimed to evaluate trends and predictors of survival after cancer diagnosis in persons living with HIV in the Caribbean, Central, and South America network for HIV epidemiology cohort.MethodsDemographic, cancer, and HIV-related data from HIV-positive adults diagnosed with cancer ≤ 1 year before or any time after HIV diagnosis from January 1, 2000-June 30, 2015 were retrospectively collected. Cancer cases were classified as AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC). The association of mortality with cancer- and HIV-related factors was assessed using Kaplan-Meier curves and Cox proportional hazards models stratified by clinic site and cancer type.ResultsAmong 15,869 patients, 783 had an eligible cancer diagnosis; 82% were male and median age at cancer diagnosis was 39 years (interquartile range [IQR]: 32–47). Patients were from Brazil (36.5%), Argentina (19.9%), Chile (19.7%), Mexico (19.3%), and Honduras (4.6%). A total of 564 ADC and 219 NADC were diagnosed. Patients with NADC had similar survival probabilities as those with ADC at one year (81% vs. 79%) but lower survival at five years (60% vs. 69%). In the adjusted analysis, risk of mortality increased with detectable viral load (adjusted hazard ratio [aHR] = 1.63, p = 0.02), age (aHR = 1.02 per year, p = 0.002) and time between HIV and cancer diagnoses (aHR = 1.03 per year, p = 0.01).ConclusionADC remain the most frequent cancers in the region. Overall mortality was related to detectable viral load and age. Longer-term survival was lower after diagnosis of NADC than for ADC, which may be due to factors unrelated to HIV.

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Section: Discussionsupporting

confidence: 94%

Survival after cancer diagnosis in a cohort of HIV-positive individuals in Latin America

Fink

Jenkins

Castilho

et al. 2018

Infect Agents Cancer

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“…At the same center as the present study (AIIMS), a retrospective study analyzing malignancy in HIV patients during the initial years of ART (2005-2013) suggested a similar infrequent occurrence of malignancy in HIV, with NHL being the most common [ 30 ]. Most regional studies from India concur that NHL is the most common malignancy in HIV and KS is very rare [ 21 - 23 , 29 - 33 ]. One of the reasons postulated is the low seroprevalence of HHV-8 in the Indian population [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diffuse large B-cell lymphoma is the most common subtype of NHL overall as well in the HIV population [ 2 , 23 , 24 ]. While EBV is commonly associated with immunodeficiency-related Hodgkin’s lymphoma, its role in the pathogenesis of NHL in HIV varies, with most cases of primary CNS lymphoma expressing EBV proteins while rarely being associated with Burkitt lymphoma [ 36 - 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2016, there were 36.7 million people living with HIV worldwide; 2.1 million of these lived in India [ 19 , 20 ]. Based on regional records, NHL is the most common cancer overall [ 21 - 24 ] and Kaposi’s sarcoma is rare [ 23 ]. Increasing access to ART [ 25 ] is expected to decrease the overall incidence of cancer in this population, but the spectrum of cancer in people living with HIV in India needs to be better understood for effective screening.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India

Sinha

Agarwal

Gupta

et al. 2019

CHR

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Background and Objectives:People living with HIV/AIDS are at an increased risk of developing cancer. The goals of this study were to obtain data on the prevalence of HIV in the cancer population and vice versa at a major tertiary cancer and HIV center in North India.Methods:This cross-sectional study was conducted over a 3-year period from July 2013 to June 2016, wherein successive HIV positive patients from an anti-retroviral therapy (ART) center were screened for malignancy. Simultaneously, successive cancer patients at the cancer center were screened for HIV. Baseline demographic details, risk factors, and laboratory investigations were obtained for all the patients.Results:Among the 999 HIV-positive patients at the ART center, the prevalence of malignancy was 2% (n=20; 95% confidence interval (CI) 1.13, 2.87). Among the 998 patients with a malignancy, the prevalence of HIV infection was 0.9% (n=9; 95% CI 0.31, 1.49). Weight loss, loss of appetite, and fever were the most common symptoms in patients with HIV and cancer. Among 29 patients with HIV and cancer, AIDS-defining cancer was found in 19 patients; non-Hodgkin’s lymphoma was the most common malignancy reported (n=13).Interpretation and Conclusion:There is a low prevalence of HIV in cancer patients as well as a low prevalence of cancer in HIV patients. AIDS-defining cancers remain much more common than non-AIDS-defining cancers. With the increased coverage of ART, it is expected that non-AIDSdefining cancers will increase, as is evident from data from more developed countries.

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“…The burden of cervical cancer is still very high in Zimbabwe mainly as a result of late presentation of disease, poor screening, diagnosis and treatment facilities which is compounded by the very high HIV incidence. In 2015, 1.4 million people were estimated to be living with HIV in Zimbabwe, and HIV augments the risk of malignancy by 10% [ 15 , 16 ]. There is a host of articles to address and report on prevention, screening and treatment in biomedical, behavioural and policy level findings of cervical cancer that have been published in different settings.…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer in Zimbabwe: a situation analysis

Kuguyo¹,

Matimba²,

Tsikai³

et al. 2017

Pan Afr Med J

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IntroductionDespite the wide-spread availability of cervical cancer prevention and screening programs in developed countries, the morbidity and mortality rates of cervical cancer in Zimbabwe are still very high. Limited resources as well as the high HIV prevalence are contributors to the high burden of cervical cancer. This paper aims to analyse the policies, frameworks and current practices in the management of cervical cancer in Zimbabwe.MethodsA review of national documents and published literature on cervical cancer prevention, screening, treatment and knowledge in Zimbabwe was done. Informal interviews were conducted to assess the practices of cervical cancer management.ResultsThrough strategic collaboration, a pilot for the HPV vaccination program is underway. The VIAC national cervical cancer screening program is being adopted into the current healthcare system. With regards to the treatment of precancerous lesions we found that the "see and treat" program has been implemented in colposcopy clinics. In addition, there are two multidisciplinary cancer treatment clinics installed in two central public hospitals. The general knowledge and understanding of cervical cancer is poor in Zimbabwe.ConclusionLimitations in resources, infrastructure, manpower, delays in treatment and patient knowledge play a role in the high morbidity and mortality of cervical cancer in Zimbabwe. The Ministry of Health needs to increase funding to expedite the availability of HPV vaccine and screening programs. Community engagement initiatives to raise awareness on cervical cancer should be established to provide education on how to prevent the development of cervical cancer, as well as promote screening for early detection.

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Spectrum of AIDS defining & non-AIDS defining malignancies in north India

Cited by 9 publications

References 28 publications

Survival after cancer diagnosis in a cohort of HIV-positive individuals in Latin America

Survival after cancer diagnosis in a cohort of HIV-positive individuals in Latin America

Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India

Cervical cancer in Zimbabwe: a situation analysis

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