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Home >> Publications >> Cancer in HIV-infected persons from the Caribbean, Central and South America.

Publication

Author(s):

Fink VI, Shepherd BE, Cesar C, Krolewiecki A, Wehbe F, Cortê©s CP, Crabtree-Ramê_rez B, Padgett D, Shafaee M, Schechter M, Gotuzzo E, Bacon M, McGowan C, Cahn P, Masys D; Caribbean Central South America Network for HIV Research Collaboration of the International Epidemiologic Databases to Evaluate AIDS Program.

Pub Title:

Cancer in HIV-infected persons from the Caribbean, Central and South America.

Pub Date:

Apr 15 2011

Journal Issue:

5

Page Number:
467-73

Journal:

Title: 
JAIDS- Journal of Acquired Immune Deficiency Syndromes
Link: 
http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2011&issue=04150&article=00012&type=abstract

PubMed: 21239992
Pub PDF: PDF icon 21239992.pdf

Abstract
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 person-years 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.

PMID: 21239992 [PubMed - indexed for MEDLINE]

PMCID: PMC3293455

 

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Citation:

Fink VI, Shepherd BE, Cesar C, Krolewiecki A, Wehbe F, Cortés CP, Crabtree-Ramírez B, Padgett D, Shafaee M, Schechter M, Gotuzzo E, Bacon M, McGowan C, Cahn P, Masys D; Caribbean Central South America Network for HIV Research Collaboration of the International Epidemiologic Databases to Evaluate AIDS Program. Cancer in HIV-infected persons from the Caribbean, Central and South America. J Acquir Immune Defic Syndr. 2011 Apr 15;56(5):467-73. doi: 10.1097/QAI.0b013e31820bb1c3. PubMed PMID: 21239992; PubMed Central PMCID: PMC3293455.