Treatment for leiomyosarcoma and leiomyoma in children with HIV infection

Yin, Xiangli; Wu, Taixiang; Yan, Yabin; Zhang, Hongying; Bu, Hong

doi:10.1002/14651858.cd007665.pub2

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…However, in contrast with literature, which reported that AIDS related malignancies declined during the cART era while the incidence of non-AIDS related cancers increased over time (31,33), in our study, the most common cancers remained Burkitt lymphoma, Kaposi sarcoma and non-Hodgkin B-cell lymphoma, as observed in low-income-resource countries (34,35). No case of leiomyosarcoma was found, even if it is now the second most frequent malignancy in HIV-infected children in the USA (36). Any significant relation between the immunovirological status (expressed by CD4 + T-cell count and viral load) and cancer risk was found.…”

Section: Discussioncontrasting

confidence: 99%

“…Incidence rates of HIV associated nephropathy (HIVAN) and HIV encephalopathy (HIVE) significantly decreased, too (22)(23)(24)(25). However, new aspects are emerging: in the low-to-middle income countries (LMICs) the incidence of bacterial pneumonia, tuberculosis, candidiasis and varicella remained stable over years despite the use of cART (26) and chronic lung disease is emerging among older children and adolescents (27); other types of renal disease (i.e., tubular dysfunction, human immunodeficiency virus immune complex kidney disease, urinary tract infections) (28)(29)(30) and milder neurocognitive deficits (i.e., lower total intelligence quotient, language impairment, poorer working memory) (31)(32)(33)(34)(35)(36)(37) are occurring always more frequently. Cancer rates considerably decreased after year 2000, when the cART use was widely diffused (38)(39)(40).…”

Section: Introductionmentioning

confidence: 99%

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Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018

et al. 2021

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Background: Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited.Methods: An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018.Results: Three hundred and fifty-four (32%) AIDS events and 26 (2%) deaths occurred overtime. Mortality rates decreased from 0.4/100 person-years in 2001–2006 to 0.27/100 person-years in 2007–2012 and 0.07/100 person-years in 2013–2018. Notably, 92% of the dead children were born in Italy, but only 50% were followed-up since birth or within three months of age. Seventy three percent of children had started cART at age ≥6 months; 23% were treated for <30 days before death. B and C clinical events progressively decreased (P < 0.0001). Opportunistic infections significantly decreased over time, but still were the most common events in all the periods (6.76/100 person-years in 2013–2018). In the last period, severe bacterial infections were the most common ones. Cancer rates were 0.07/100; 0.17/100; 0.07/100 person-years in the three periods, respectively.Conclusions: Progressive reductions both in mortality and in rates of class B and C clinical events and OIs have been observed during the cART era. However, deaths were still registered; more than half of dead children were enrolled after birth and had belatedly started cART.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018

et al. 2021

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“…Based on the fact that there are no randomized or clinical controlled trials and most of the data is based on case reports and small series, they conclude that it is likely best to treat each patient with a case-by-case manner until larger, more rigorous studies are carried out [57]. In some cases, conservative management and simple observation alone may be appropriate for some of these extremely ill patients [27, 32].…”

Section: Resultsmentioning

confidence: 99%

AIDS-Related EBV-Associated Smooth Muscle Tumors: A Review of 64 Published Cases

Purgina

Rao

Miettinen

et al. 2011

Pathology Research International

142

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The number of reported cases of smooth muscle tumor (SMT) arising in patients with AIDS has been increasing since the mid-1990s. The aim of this study is to characterize the epidemiology, clinical manifestations, pathologic features, prognosis and, management of Epstein-Barr virus-related SMT (EBV-SMT) in patients with AIDS. An English language literature search identified 53 articles including 64 reported cases of EBV-SMT. The majority of these reports involved patients who were young, severely immunosuppressed, and had multifocal tumors. The central nervous system was the most common site to be involved. Histologically, tumors had smooth muscle features and were immunoreactive for muscle markers and all but two tumors demonstrated the presence of EBV by either immunohistochemistry, in situ hybridization, and/or PCR. While mitoses and/or necrosis were used to separate leiomyoma from leiomyosarcoma, these features did not correlate with clinical outcome. Treatment included primarily resection, and less often radiotherapy, chemotherapy and highly active antiretroviral therapy (HAART). Overall, EBV-SMTs appear to have variable aggressiveness and clinical outcome and may exhibit a more favorable prognosis compared to conventional leiomyosarcoma. Tumor-related death from EBV-SMT occurred in only 4 of 51 patients.

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Epstein-Barr virus associated hepatic smooth muscle tumor in a patient with acquired immunodeficiency syndrome

Zhou

Guo

et al. 2020

Medicine

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Introduction: Epstein-Barr virus (EBV) associated smooth muscle tumors (SMTs) usually present under the condition of immunosuppression, including congenital immunodeficiency syndrome-SMT, post-transplantation-SMT and HIV-SMT. HIV-SMTs are most likely to invade the central nervous system, followed by the liver, lungs, and other locations. [ 1 ] Many laboratory techniques, including serological techniques, polymerase chain reaction and immunohistochemistry (IHC), are employed to determine the aetiologies of these tumours. With respect to therapy, surgical resection is the main treatment. In patients with immunodeficiency, improving immune status is significant for defending against other viruses. We describe a case of the primary focus of SMT in the liver of HIV-positive patient without any metastasis. Patient concerns: A young male HIV-positive patient complained of fever and abdominal pain for 2 months. Diagnosis: IHC of liver tissue confirmed the finding: EBV-related smooth muscle tumor. Interventions: Given the patient's general condition, he was not a suitable candidate for surgical resection. He was given antibiotics, antifungal agents and EBV-directed agents to control infection as well as highly active antiretroviral therapy to enhance the immunity. Outcomes: The patient's symptoms improved. He was discharged. Conclusions: In conclusion, EBV-related HIV-SMTs is a rare neoplasm found in the liver among immunodeficient patients. This case highlights that a variety of examinations such as IHC for smooth muscle markers (smooth muscle actin and desmin) and EBER, as well as polymerase chain reaction for EBV DNA should be done when diagnoses are ambiguous.

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Treatment for leiomyosarcoma and leiomyoma in children with HIV infection

Cited by 6 publications

References 35 publications

Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018

Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018

AIDS-Related EBV-Associated Smooth Muscle Tumors: A Review of 64 Published Cases

Epstein-Barr virus associated hepatic smooth muscle tumor in a patient with acquired immunodeficiency syndrome

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