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Journal of the International AIDS Society

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Open Access 01-12-2010 | Research

Cancers in the TREAT Asia HIV Observational Database (TAHOD): a retrospective analysis of risk factors

Authors: Kathy Petoumenos, Eugenie Hui, Nagalingeswaran Kumarasamy, Stephen J Kerr, Jun Yong Choi, Yi-Ming A Chen, Tuti Merati, Fujie Zhang, Poh-Lian Lim, Somnuek Sungkanuparph, Sanjay Pujari, Sasheela Ponnampalavanar, Rosanna Ditangco, Christopher KC Lee, Andrew Grulich, Matthew G Law, TREAT Asia HIV Observational Database

Published in: Journal of the International AIDS Society | Issue 1/2010

Abstract

Background

This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer.

Methods

TREAT Asia HIV Observational Database (TAHOD) sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs), and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR) and unrelated (NADC-IUR).

Results

A total of 617 patients were included in this study: 215 cancer cases and 402 controls from 13 sites. The majority of cancer cases were male (71%). The mean age (SD) for cases was 39 (10.6), 46 (11.5) and 44 (13.7) for ADCs, NADC-IURs and NADCs-IR, respectively. The majority (66%) of cancers were ADCs (16% Kaposi sarcoma, 40% non-Hodgkin's lymphoma, and 9% cervical cancer). The most common NADCs were lung (6%), breast (5%) and hepatocellular carcinoma and Hodgkin's lymphoma (2% each). There were also three (1.4%) cases of leiomyosarcoma reported in this study. In multivariate analyses, individuals with CD4 counts above 200 cells/mm³ were approximately 80% less likely to be diagnosed with an ADC (p < 0.001). Older age (OR: 1.39, p = 0.001) and currently not receiving antiretroviral treatment (OR: 0.29, p = 0.006) were independent predictors of NADCs overall, and similarly for NADCs-IUR. Lower CD4 cell count and higher CDC stage (p = 0.041) were the only independent predictors of NADCs-IR.

Conclusions

The spectrum of cancer diagnoses in the Asia region currently does not appear dissimilar to that observed in non-Asian HIV populations. One interesting finding was the cases of leiomyosarcoma, a smooth-muscle tumour, usually seen in children and young adults with AIDS, yet overall quite rare. Further detailed studies are required to better describe the range of cancers in this region, and to help guide the development of screening programmes.

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Title: Cancers in the TREAT Asia HIV Observational Database (TAHOD): a retrospective analysis of risk factors
Authors: Kathy Petoumenos
Eugenie Hui
Nagalingeswaran Kumarasamy
Stephen J Kerr
Jun Yong Choi
Yi-Ming A Chen
Tuti Merati
Fujie Zhang
Poh-Lian Lim
Somnuek Sungkanuparph
Sanjay Pujari
Sasheela Ponnampalavanar
Rosanna Ditangco
Christopher KC Lee
Andrew Grulich
Matthew G Law
TREAT Asia HIV Observational Database
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Journal of the International AIDS Society / Issue 1/2010
Electronic ISSN: 1758-2652
DOI: https://doi.org/10.1186/1758-2652-13-51

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