Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

Ruffieux, Yann; Muchengeti, Mazvita; Egger, Matthias; Efthimiou, Orestis; Bartels, Lina; Olago, Victor; Davidović, Maša; Dhokotera, Tafadzwa; Bohlius, Julia; Singh, Elvira; Rohner, Eliane

doi:10.1093/cid/ciab087

Cited by 23 publications

(30 citation statements)

References 40 publications

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“…There were 16 global studies including the African or SSA regions ( 27 , 46 , 69 , 104 , 106 , 108 , 109 , 117 , 121 , 122 , 127 , 131 , 142 , 144 , 145 , 158 ) and there were 16 African multi-country studies ( 2 , 6 , 87 , 119 , 120 , 138 , 140 , 141 , 143 , 148 – 154 ). From the single-country studies, majority were done in Nigeria ( n = 17) ( 24 , 25 , 28 , 29 , 34 , 45 , 54 , 64 , 72 , 75 , 92 , 93 , 103 , 113 , 116 , 124 , 137 ) and South Africa ( n = 20) ( 10 , 26 , 36 , 42 , 55 , 65 , 80 – 83 , 86 , 88 , 89 , 91 , 98 , 105 , 110 , 125 , 129 , 135 ), followed by Uganda ( n = 10) ( 35 , 40 , 48 , …”

Section: Resultsmentioning

confidence: 99%

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

Musekiwa

Moyo²,

Mohammed³

et al. 2022

Front. Public Health

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BackgroundCancer remains a major public health problem, especially in Sub-Saharan Africa (SSA) where the provision of health care is poor. This scoping review mapped evidence in the literature regarding the burden of cervical, breast and prostate cancers in SSA.MethodsWe conducted this scoping review using the Arksey and O'Malley framework, with five steps: identifying the research question; searching for relevant studies; selecting studies; charting the data; and collating, summarizing, and reporting the data. We performed all the steps independently and resolved disagreements through discussion. We used Endnote software to manage references and the Rayyan software to screen studies.ResultsWe found 138 studies that met our inclusion criteria from 2,751 studies identified through the electronic databases. The majority were retrospective studies of mostly registries and patient files (n = 77, 55.8%), followed by cross-sectional studies (n = 51, 36.9%). We included studies published from 1990 to 2021, with a sharp increase from 2010 to 2021. The quality of studies was overall satisfactory. Most studies were done in South Africa (n = 20) and Nigeria (n = 17). The majority were on cervical cancer (n = 93, 67.4%), followed by breast cancer (67, 48.6%) and the least were on prostate cancer (48, 34.8%). Concerning the burden of cancer, most reported prevalence and incidence. We also found a few studies investigating mortality, disability-adjusted life years (DALYs), and years of life lost (YLL).ConclusionsWe found many retrospective record review cross-sectional studies, mainly in South Africa and Nigeria, reporting the prevalence and incidence of cervical, breast and prostate cancer in SSA. There were a few systematic and scoping reviews. There is a scarcity of cervical, breast and prostate cancer burden studies in several SSA countries. The findings in this study can inform policy on improving the public health systems and therefore reduce cancer incidence and mortality in SSA.

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Section: Resultsmentioning

confidence: 99%

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

Musekiwa

Moyo²,

Mohammed³

et al. 2022

Front. Public Health

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“…We examined CD4 trajectories and cancer risk in 3.5 million SAM Study participants with at least two CD4 counts and 1 year of follow-up. 29 When assuming a linear relationship between time-updated CD4 cell counts and the log-hazard, the association between low CD4 cell count and higher rates of cancer was most substantial in conjunctival cancer (adjusted HR (aHR) per decrease of 100 CD4 cells/µL: 1.46; 95% CI: 1.38–1.54), followed by Kaposi sarcoma (aHR: 1.23, 95% CI: 1.20 to 1.26) and non-Hodgkin's lymphoma (aHR: 1.18; 95% CI: 1.14 to 1.22). Among the infection-unrelated cancers, we found low CD4 cell count to be associated with higher rates of oesophageal cancer (aHR: 1.06; 95 CI 1.00 to 1.11), but not with higher rates of lung, breast or prostate cancer.…”

Section: Cohort Descriptionmentioning

confidence: 99%

“…Among the infection-unrelated cancers, we found low CD4 cell count to be associated with higher rates of oesophageal cancer (aHR: 1.06; 95 CI 1.00 to 1.11), but not with higher rates of lung, breast or prostate cancer. 29 …”

Section: Cohort Descriptionmentioning

confidence: 99%

Cohort profile: the South African HIV Cancer Match (SAM) Study, a national population-based cohort

et al. 2022

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PurposeThe South African HIV Cancer Match (SAM) Study is a national cohort of people living with HIV (PLWH). It was created using probabilistic record linkages of routine laboratory records of PLWH retrieved by National Health Laboratory Services (NHLS) and cancer data from the National Cancer Registry. The SAM Study aims to assess the spectrum and risk of cancer in PLWH in the context of the evolving South African HIV epidemic. The SAM Study’s overarching goal is to inform cancer prevention and control programmes in PLWH in the era of antiretroviral treatment in South Africa.ParticipantsPLWH (both adults and children) who accessed HIV care in public sector facilities and had HIV diagnostic or monitoring laboratory tests from NHLS.Findings to dateThe SAM cohort currently includes 5 248 648 PLWH for the period 2004 to 2014; 69% of these are women. The median age at cohort entry was 33.0 years (IQR: 26.2–40.9). The overall cancer incidence in males and females was 235.9 (95% CI: 231.5 to 240.5) and 183.7 (181.2–186.2) per 100 000 person-years, respectively.Using data from the SAM Study, we examined national cancer incidence in PLWH and the association of different cancers with immunodeficiency. Cancers with the highest incidence rates were Kaposi sarcoma, cervix, breast, non-Hodgkin's lymphoma and eye cancer.Future plansThe SAM Study is a unique, evolving resource for research and surveillance of malignancies in PLWH. The SAM Study will be regularly updated. We plan to enrich the SAM Study through record linkages with other laboratory data within the NHLS (eg, tuberculosis, diabetes and lipid profile data), mortality data and socioeconomic data to facilitate comprehensive epidemiological research of comorbidities among PLWH.

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“…People with HIV (PWH) have an increased risk of several cancers compared with HIV-negative individuals, most importantly infection-related cancer (IRC) [1][2][3]. This is considered mainly because of HIV-induced immunosuppression causing impaired control of oncogenic viruses [4,5]. Since the introduction of effective antiretroviral therapy (ART), the incidence of IRC has declined in PWH but remain higher than for HIV-negative individuals [1,6].…”

Section: Introductionmentioning

confidence: 99%

“…Studies with access to nation-wide data regarding cancer diagnoses and HIV-related factors, such as HIV viral load and CD4 þ cell count, are currently lacking. Preceding studies often had to rely on data from multiple HIV cohorts and multiple cancer registries with linking based on, for example, probabilistic matching algorithms [5,7].…”

Section: Introductionmentioning

confidence: 99%

Failure to restore CD4+ cell count associated with infection-related and noninfection-related cancer

Malmström

Wagner

Yilmaz

et al. 2021

Aids

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Results: Incidence and relative risk of infection-related cancer decreased but remained higher in people with HIV (PWH) than in HIV-negative. The proportion attributable to infection remained higher in PWH than in HIV-negative (44 vs. 9%). Women with HIV had lower risk of infection-related cancer than men with HIV [adjusted hazard ratio (adjHR) 0.6, 95% CI 0.4-0.9], mainly driven by lower incidence of Kaposi's sarcoma (adjHR 0.1, 95% CI 0.0-0.4). Current viral suppression (adjHR 0.3, 95% CI 0.2-0.5) was associated with lower risk of infection-related cancer. Current CD4 þ cell count less than 200 cells/ml was associated with both infection-related (adjHR 15.3, 95% CI 10.7-21.8) and noninfection-related cancer (adjHR 2.5, 95% CI 1.5-4.1), as was CD4 þ cell count increases less than 100 cells/ml post antiretroviral therapy (ART) (infection-related cancer adjHR 6.6, 95% CI 4.2-10.6, noninfection-related cancer adjHR 2.0, 95% CI 1.2-3.3). Conclusion:Current CD4 þ cell count and failure to restore CD4 þ cell count both associated with infection and noninfection-related cancer. Viral suppression associated with lower risk of infection-related cancer. Early HIV detection and early adherent ART remain essential for cancer prevention.

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Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

Cited by 23 publications

References 40 publications

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

Cohort profile: the South African HIV Cancer Match (SAM) Study, a national population-based cohort

Failure to restore CD4+ cell count associated with infection-related and noninfection-related cancer

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