Cancer spectrum in HIV-infected patients: A zonal hospital experience in Tanzania

Mremi, Alex; Mswima, Jackline; Mlay, Mathew G.; Bartholomew, Henry; Alloyce, Julius Pius; Mmbaga, Blandina T.; Bartlett, John A.

doi:10.1016/j.ctarc.2020.100213

Cited by 7 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was similar to the nine percent prevalence of HIV-cancer comorbidity in a study by Mremi et al 13 in a Tanzanian zonal hospital but lower than what was described in a Ugandan study, which demonstrated a 23% prevalence. 11 The lower prevalence in our study may be influenced by the patient catchment of a private institution with higher socioeconomic status and may not reflect that in a middle or lower socioeconomic population.…”

Section: Discussionsupporting

confidence: 86%

“…The changing trend and shift toward NADCs among PLHIV in SSA were demonstrated in Guinea and Tanzania with the 79% and 72% prevalence of NADCs, respectively, underscoring the need to perform diagnostic HIV testing in patients with cancer irrespective of the cancer type. 12 , 13 Among the NADCs, the commonest malignancy among HIV-positive patients in the study participants was breast cancer. The predominance of breast cancer among NADCs has been shown in SSA.…”

Section: Discussionmentioning

confidence: 99%

“…In Tanzania, a retrospective study in a zonal referral hospital among HIV-positive patients enrolled between 2009 and 2019 identified 9% of PLHIV who also had histologically confirmed cancers, 72% of which were NADCs. 13 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

Muturi

Mwanzi

Riunga

et al. 2023

JCO Global Oncology

View full text Add to dashboard Cite

PURPOSE Antiretroviral therapy (ART) has resulted in a higher life expectancy of persons living with HIV. This has led to an aging population at risk for both non–AIDS-defining cancers (NADCs) and AIDS-defining cancers (ADCs). HIV testing among patients with cancer in Kenya is not routinely performed, making its prevalence undefined. The aim of our study was to determine the prevalence of HIV and the spectrum of malignancies among HIV-positive and HIV-negative patients with cancer attending a tertiary hospital in Nairobi, Kenya. MATERIALS AND METHODS We conducted a cross-sectional study between February 2021 and September 2021. Patients with a histologic cancer diagnosis were enrolled. Demographic data and HIV- and cancer-related clinical variables were obtained. HIV pretest counseling and consent were done, and testing was performed using a fourth-generation assay. Positive results were confirmed using a third-generation assay. RESULTS We enrolled 301 patients with cancer; 67.8% (204 of 301) were female; the mean age was 50.7 ± 12.5 years. From our cohort, 10.6% (95% CI, 7.4 to 14.7, n = 32 of 301) of patients were HIV-positive with the prevalence of a new HIV diagnosis of 0.7% (n = 2 of 301). Of the HIV-positive patients, 59.4% (19 of 32) had a NADC. The commonest NADC was breast cancer (18.8%; 6 of 32), whereas non-Hodgkin lymphoma (18.8%; 6 of 32) and cervical cancer (18.8%; 6 of 32) were the most prevalent ADCs among HIV-positive patients. CONCLUSION The prevalence of HIV infection among patients with cancer was twice the Kenya national HIV prevalence. NADCs comprised a larger percentage of the cancer burden. Universal opt-out HIV testing of patients attending for cancer care regardless of cancer type may facilitate early recognition of HIV-infected patients and aid in appropriate selection of ART and cancer therapies and preventive strategies.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

Muturi

Mwanzi

Riunga

et al. 2023

JCO Global Oncology

View full text Add to dashboard Cite

show abstract

“…Our ndings appear to be in line with those of a retrospective study of HIV patients in Tanzania, which indicated that the prevalence of cancer among HIV-infected patients was 9%, with an upward trend over time. (28) Globally, the roll out of ART in HIV patients has signi cantly reduced the rate of hospitalization among HIV patients from cancers of any type. (29,30) Nevertheless, non-AIDS de ning cancers will remain a signi cant co-morbidity in PLHIV due to increased longevity.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Non-Communicable Diseases among Hospitalized HIV Positive Patients at Lira Regional Referral Hospital, Northern Uganda: Retrospective Chart Review 2016-2020

Bernard

Bosco

Bony

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Non-communicable diseases(NCDs) are increasing rapidly in sub-Sahara Africa including Uganda. Knowledge of the effect of long-term antiretroviral therapy(ART) and emergence of NCDs on hospital utilization remain scant. This study aimed to assess the burden of major NCDs and predictors of mortality among hospitalized HIV positive patients in the medical wards at Lira regional referral hospital in Northern Uganda.Method: We conducted a retrospective cross-sectional chart review of hospitalized patients from the male and female medical wards between 2016 and 2020. The prevalence of NCDs was estimated and status at discharge determined. Binary and multi-variable regression analyses were performed to determine predictors of mortality with statistical significance set at 0.05 p-value. Results: A total of 445 patient files were examined, with 49 percent (n=218) of them revealing HIV status. Males made up 53% of the total number of patients studied (n=226). In HIV positive patients, the prevalence of at least one NCD, two NCDs, and three or more NCDs multi-morbidity was 73 percent, 16 percent, and 2 percent, respectively. In HIV negative controls, the prevalence of at least one NCD, two NCDs, and three or more NCDs was 62 percent, 28 percent, and 6 percent, respectively, compared to HIV positive controls. Cardiovascular diseases, diabetes, cancers, chronic lung disease, liver diseases, and mental disorders were found in 19.52 percent (CI: 14.67-25.49) of HIV positive patients versus 36.99 percent (CI: 30.06-44.50), 4.4.65 percent (CI: 02.51-08.51) versus 22.65 percent (CI: 17.57-29.74 p-value= 0.001), 13.55 percent (CI: 09.56-18.87) versus 9. 56 percent (CI: 05.99-14.89), 04.65 percent (02.51-08.47) versus 5.62(03.03-10.18), 27.91 percent (22.27-34.32) versus 29.53 (23.48-36.41), and 26.63 percent (21.10-33.02)versus 06.82 (03.89-11.68,p-value-=<0.001). In HIV patients, being middle-aged (40-50 years) was the sole independent predictor of mortality.Conclusion. HIV positive inpatients had a lower prevalence of major NCDs than HIV negative inpatients, albeit, this was not statistically significant except for diabetes mellitus and mental disorders. Increasing age is a significant predictor of mortality in hospitalized HIV positive patients. Prioritizing screening infrastructure and service capacity to reduce the burden of NCDs in PLHIV is critically important.

show abstract

“…The high incidence of both ADCs and NADCs is not limited to the United States -while early treatment with ART has reduced the incidence of Kaposi sarcoma and NHL in PWH, the incidence of NADCs continues to increase in some regions of SSA [8]. Several studies from other regional countries have reported the distribution of various cancers, including the proportion of ADCs vs. NADCs [9][10][11][12], but few have documented changes in trends over time. Two studies from South Africa both documented substantial declines in ADCs that were driven by declines in Kaposi sarcoma diagnoses [13,14].…”

Section: Introductionmentioning

confidence: 99%

Cancer in patients with and without HIV infection in the national cancer registry of Rwanda

Hagenimana

Kodan

George

et al. 2022

Aids

View full text Add to dashboard Cite

Objective:As antiretroviral therapy (ART) has been widely scaled up in Rwanda, life expectancies among people with HIV (PWH) have increased. With increasing viral suppression, AIDS-defining cancers (ADCs) typically decrease; however, as the PWH population ages, non-AIDS-defining cancers (NADCs) will be expected to increase. The aim of this study was to compare cancer diagnoses between PWH and patients without HIV in Rwanda and to describe the changes in the number and types of cancer over time.Design:Retrospective cohort study.Methods:Rwanda National Cancer Registry (RNCR) recorded the HIV status, primary site, and morphological description for cancer diagnoses from 2007 to 2018. Descriptive analyses were carried out by cancer group (HIV+ and HIV–). A portion of patients whose HIV status was unknown (63%) were excluded from the present analysis.Results:Among the 20 258 cases registered in the Registry, there were 1048 PWH and 6359 HIV– individuals. The proportion of ADCs were significantly higher in the PWH group compared to those without HIV (P < 0.001). Among PWH, there was a longitudinal increase in NADCs and a decrease in ADCs (P < 0.001) over time. Among the ADCs in the PWH group, there was a significant decline in Kaposi sarcoma cases over time.Conclusions:The study demonstrates a decreasing frequency of ADCs driven by declines in Kaposi sarcoma diagnoses and an increased frequency of NADCs among PWH in Rwanda over time. These findings support a need for focusing early detection and management efforts on NADCs, as they begin to play a larger role in the disease processes that affect the aging PWH population.

show abstract

Cancer spectrum in HIV-infected patients: A zonal hospital experience in Tanzania

Cited by 7 publications

References 37 publications

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

HIV Prevalence and Characteristics Among Patients With AIDS-Defining and Non–AIDS-Defining Cancers in a Tertiary Hospital in Kenya

The Burden of Non-Communicable Diseases among Hospitalized HIV Positive Patients at Lira Regional Referral Hospital, Northern Uganda: Retrospective Chart Review 2016-2020

Cancer in patients with and without HIV infection in the national cancer registry of Rwanda

Contact Info

Product

Resources

About