Brief Report: Malignancies in Adults Living With HIV in Asia

Abstract

Background-Haematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence, risk factors for, and outcomes of haematological and non-haematological malignancies in PLHIV in Asia. Methods-Incidence of malignancy after cohort enrolment was evaluated. Factors associated with development of haematological and non-haematological malignancy were analysed using competing risk regression and survival time using Kaplan-Meier. Results-Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) haematological (0.08 per 100 person-years (/100PY)), and 73 (1%) non-haematological (0.17/100PY). Of the haematological malignancies, non-Hodgkin lymphoma was predominant (n=26, 76%): immunoblastic (n=6, 18%), Burkitt (n=5, 15%), diffuse large B-cell (n=5, 15%), and unspecified (n=10, 30%). Others include central nervous system lymphoma (n=7, 21%), and myelodysplastic syndrome (n=1, 3%). Non-haematological malignancies were mostly Kaposi's sarcoma (n=12, 16%) and cervical cancer (n=10, 14%). Risk factors for haematological malignancy included age >50 vs. ≤30 years (sub-hazard ratio [SHR]=6.48, 95%CI 1.79-23.43), and being from a high-income vs. a lower-middle-income country (SHR=3.97, 95%CI 1.45-10.84). Risk was reduced with CD4 351-500 cells/µL (SHR=0.20, 95%CI 0.05-0.74), and CD4 >500 cells/µL (SHR=0.14, 95%CI 0.04-0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for non-haematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a haematological malignancy had shorter survival time compared to non-haematological malignancy. Conclusions-Non-haematological malignancies were common but NHL was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential under-diagnosis of cancer in low-income settings.

Myelodysplastic syndrome in patients living with HIV Infection

“…One percent of patients (n=107) developed a malignancy, 31% of them were hematological and only one (0.9%) was MDS. 4 …”

Prognostic Factors, Survival Analyses and the Risk of Second Primary Cancer: A Population-Based Study on Burkitt Lymphoma/Leukemia

“…Kaposi sarcomas and BL/L have a high rate of incidence in HIV/AIDS individuals. Despite the change in pattern of secondary cancers after a Kaposi sarcoma in the era of antiretroviral therapy, NHL remains one of the most common [ 42 , 43 ].…”