Cancer in HIV-Infected Persons From the Caribbean,Central and South America.

FINK V; SHEPHERD B; CESAR C; KROLEWIECKI A; WEHBE F; CORTES C; CRABTREE- RAMIREZ B; PADGETT D; SHAFAEE M; SCHECHTER M; GOTUZZO E; BACON M; MCGOWAN C; CAHN P; MASYS D

JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES (1999)

LIPPINCOTT WILLIAMS & WILKINS

Lugar: Filadelfia; Año: 2011 vol. 56 p. 467 - 473

1525-4135

Background: HIV-infected individuals have heightened cancer risk.With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS–defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied. Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases. Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed .1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = ,0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 personyears of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation. Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.