Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study

Abstract

Background: The advent of highly active antiretroviral therapy (HAART) in 1996 led to a decrease in the incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), but not of other cancers, among people with HIV or AIDS (PWHA). It also led to marked increases in their life expectancy. Methods: We conducted a record-linkage study between the Swiss HIV Cohort Study and nine Swiss cantonal cancer registries. In total, 9429 PWHA provided 20 615, 17 690, and 15 410 person-years in the pre-, early-, and late-HAART periods, respectively. Standardised incidence ratios in PWHA vs the general population, as well as age-standardised, and age-specific incidence rates were computed for different periods. Results: Incidence of KS and NHL decreased by several fold between the pre- and early-HAART periods, and additionally declined from the early- to the late-HAART period. Incidence of cancers of the anus, liver, non-melanomatous skin, and Hodgkin's lymphoma increased in the early- compared with the pre-HAART period, but not during the late-HAART period. The incidence of all non-AIDS-defining cancers (NADCs) combined was similar in all periods, and approximately double that in the general population. Conclusions: Increases in the incidence of selected NADCs after the introduction of HAART were largely accounted for by the ageing of PWHA.

FDG-PET Imaging in HIV Infection and Tuberculosis

“…67,75 In most series of cases, the histologic pattern differs from the general population in that mixed cellularity is the most commonly reported pattern rather than nodular sclerosis. Lymphocyte-depleted histology has also been observed more often in the setting of HIV infection.…”

Chylous ascites secondary to Hodgkin’s lymphoma in a HIV/aids patient: case report and literature review

“…HL associated to HIV seems to be increasing in frequency, 1,18 due reduction of incidence of others cancers caused by HAART. This entity has a different epidemiological profile in HIV people compared with non-HIV ones 19 : a) the incidence peak occurs ten years later; b) it has an incidence tenfold higher; c) the most common histological subtype is mixed cellularity (as this case) in contrast with nodular sclerosis in non-HIV; and d) bone marrow infiltration is more frequent.…”

“…1 Chylous ascites (CA) is a condition known since 16th century, but it is an infrequent manifestation of malignancies, and it is even uncommon as presentation of HL. 2 In HIV/aids population, the occurrence of CA seems to be mainly due to infectious diseases (Table 1).…”

Infecção VIH e Neoplasias Não Definidoras de SIDA: Experiência de um Centro

“…[1][2][3][4] Com a introdução da terapêutica anti-retroviral de alta potência (TARV), e consequente aumento da sobrevida, assistimos a uma mudança do espectro e evolução das patologias relacionadas com a infecção por VIH, nomeadamente das doenças oncológicas, com tendência para o aumento das Neoplasias Não Definidoras (NNDS) em deterimento das Definidoras de SIDA (NDS). [2][3][4][5][6][7][8] Revisões anteriores apontam para uma frequência das neoplasias entre duas e quatro vezes superior à população geral, com uma incidência variável de acordo com idade, sexo, raça, tipo de neoplasia e região geográfica, sendo as mais frequentes: o linfoma de Hodgkin, neoplasia do pulmão, e os carcinomas relacionados com vírus oncogénicos como o carcinoma hepatocelular e neoplasia do canal anal. 3,4,9,10 As NNDS geralmente ocorrem em doentes mais jovens, têm uma apresentação atípica e mais agressiva, condicionando uma rápida progressão da doença, com altas taxa de reci-Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com Fevereiro MC.…”