Malignancies in HIV-infected patients – incidence and predictors of survival in a Romanian health care facility

C. Oprea, I. Ianache, P. Ionescu, E. Ceausu, P. Calistru,

Abstract: Objective. To estimate incidence and survival in HIV-infected patients with malignancies. Methods. Retrospective study on patients with malignancies from a single HIV center between January 2007 and December 2014. Malignancies were classified in ADMs (AIDS-defining malignancies) and nADMs (non AIDS-defining malignancies) (CDC 1993). Statistical analysis was performed using STATA 20.
Results. From 12,298 person-years (PY), 91 (3.2%) were diagnosed with malignancies (incidence 7.39/1000 PY): 57 (62.6%) ADMs and 34 (37.3%) nADMs. Median age (IQR) at HIV and cancer diagnosis was 32 years (1-70) respectively 34 years (34-74). The most common ADMs were: non-Hodgkin's lymphoma NHL 31 (54.3%), Kaposi Sarcoma KS 17 (29.8%) and cervical cancer 9 (15.7 %). Among nADM, Hodgkin’s lymphoma (HL) was the most frequent: 10 cases (29.4%). Patients with ADM had significantly lower nadir and median CD4 cell count/mm3 at cancer diagnosis compared to NADM (47 vs. 91 and 123 vs. 306 (p<0.01) and higher median HIV viral loads log10 (5.3 vs. 3.4). Kaplan-Meier survival estimates showed that patients with NHL had significantly worse survival than those with HL or KS (p=0.03). All-cause annual death rate was 12.8% and significantly decreased to 11.1% and 7.6% for patients on cART and a combination of cART and chemotherapy respectively (p< 0.01).
Conclusion. Incidence of malignancies slightly increased over the years. ADM were more frequent than nADM. The mortality rate was high, but chemotherapy and cART improved survival rates in both groups.
Keywords: HIV infection, ADMs, nADMs, incidence, survival

Conclusion. Incidence of malignancies slightly increased over the years. ADM were more frequent than nADM. The mortality rate was high, but chemotherapy and cART improved survival rates in both groups.&redirect_uri=http://rjlm.ro/index.php/arhiv/567' class='share_fb'>