Spectrum of malignancies in human immunodeficiency virus – positive patients at a Tertiary Care Centre in South India

Tr, Paul; Ms, Uppin; Sg, Uppin; Radhika, K; Ak, Prayaga; Challa, Sundaram; Vs, Reddy; Dr, Rao; Rajappa, Senthil; Vr, Sreenivasan

doi:10.4103/0019-509x.175295

Cited by 5 publications

(6 citation statements)

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“…10 e authors mentioned that this nding might be because of the low seroprevalence of Kaposi sarcoma-associated herpesvirus in the Asian population. 10 ree di erent studies from southern India have also not reported the incidence of Kaposi Sarcoma in their series of HIV-AIDS patients with malignancies, [11][12][13] and similar ndings were also reported in a study from northern India. 9 e incidence of other immunode ciency-related malignancies was identical to those reported in other studies in the literature.…”

Section: Discussionsupporting

confidence: 55%

Patterns of malignancies in patients with HIV-AIDS: a single institution observational study

Haleshappa¹

2018

JCSO

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BackgroundWith the widespread use of antiretroviral therapy in patients with HIV-AIDS, a prolonged life expectancy is now evident. This has led to an increased incidence of malignancies in this patient population. The spectrum of malignancies in these patients differs worldwide. Objective To study the patterns of AIDS-de ning malignancies (ADMs) and non-AIDS-de ning malignancies (NADMs) in patients in India with HIV-AIDS and to analyze the correlation of CD4 counts with the malignancies. Methods This retrospective study included patients presenting with a malignancy and coexisting HIV-AIDS from January 2013 through December 2016. Patients with CD4 counts at the time of diagnosis of malignancy and having received treatment were analyzed. Analyses of the patient characteristics and correlation of CD4 counts with ADM and NADM were performed. Results A total of 285 patients were evaluated. The median age was 44.8 years (range, 5-80 years). The mean CD4 count was 235.4 cells/mm 3 (range, 50-734 cells/mm 3 ; reference range, 500-1,500 cells/mm 3 ). Cervical cancer was the most common malignancy in women, and non-Hodgkin lymphoma (NHL) was the most common among men. There was a statistically signi cant difference in CD4 counts between ADMs and NADMs (P = .03). A statistical difference was also noted when the CD4 counts of patients with NHL were compared with other malignancies. However, there was no statistically signi cant difference noted when CD4 counts of patients with cervical cancer were compared with NADM (P = .914). Limitations This was a retrospective study and included only patients receiving treatment for malignancies at a single institution. Conclusions NHL and cervical cancer continue to be the most common malignancies in patients with HIV-AIDS in developing countries. NHL tends to occur in patients with lower CD4 counts. Funding/sponsorship None.

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Section: Discussionsupporting

confidence: 55%

Patterns of malignancies in patients with HIV-AIDS: a single institution observational study

Haleshappa¹

2018

JCSO

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“…At the same center as the present study (AIIMS), a retrospective study analyzing malignancy in HIV patients during the initial years of ART (2005-2013) suggested a similar infrequent occurrence of malignancy in HIV, with NHL being the most common [30]. Most regional studies from India concur that NHL is the most common malignancy in HIV and KS is very rare [21-23, 29-33]. One of the reasons postulated is the low seroprevalence of HHV-8 in the Indian population [34].…”

Section: Discussionmentioning

confidence: 82%

“…In 2016, there were 36.7 million people living with HIV worldwide; 2.1 million of these lived in India [19, 20]. Based on regional records, NHL is the most common cancer overall [21-24] and Kaposi’s sarcoma is rare [23]. Increasing access to ART [25] is expected to decrease the overall incidence of cancer in this population, but the spectrum of cancer in people living with HIV in India needs to be better understood for effective screening.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India

Sinha

Agarwal

Gupta

et al. 2019

CHR

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Background and Objectives:People living with HIV/AIDS are at an increased risk of developing cancer. The goals of this study were to obtain data on the prevalence of HIV in the cancer population and vice versa at a major tertiary cancer and HIV center in North India.Methods:This cross-sectional study was conducted over a 3-year period from July 2013 to June 2016, wherein successive HIV positive patients from an anti-retroviral therapy (ART) center were screened for malignancy. Simultaneously, successive cancer patients at the cancer center were screened for HIV. Baseline demographic details, risk factors, and laboratory investigations were obtained for all the patients.Results:Among the 999 HIV-positive patients at the ART center, the prevalence of malignancy was 2% (n=20; 95% confidence interval (CI) 1.13, 2.87). Among the 998 patients with a malignancy, the prevalence of HIV infection was 0.9% (n=9; 95% CI 0.31, 1.49). Weight loss, loss of appetite, and fever were the most common symptoms in patients with HIV and cancer. Among 29 patients with HIV and cancer, AIDS-defining cancer was found in 19 patients; non-Hodgkin’s lymphoma was the most common malignancy reported (n=13).Interpretation and Conclusion:There is a low prevalence of HIV in cancer patients as well as a low prevalence of cancer in HIV patients. AIDS-defining cancers remain much more common than non-AIDS-defining cancers. With the increased coverage of ART, it is expected that non-AIDSdefining cancers will increase, as is evident from data from more developed countries.

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“…The spectrum of HIV/AIDS-related malignancies in India differs from that reported in the Western literature [5910]. This difference may be due to the low prevalence of human herpesvirus 8 in the Indian population or to differential patterns of HIV transmission, with the heterosexual route the most common in India [11].…”

Section: Discussionmentioning

confidence: 99%

“…The exact burden of HIV/AIDS-associated cancers in India is not known. Kaposi's sarcoma is the most frequent AIDS-defining cancer in the Western world, while non-Hodgkin's lymphoma (NHL) is most commonly reported in Indian literature [456]. We undertook the current study to evaluate the epidemiology and outcomes of HIV/AIDS-related lymphoma (ARL) in a tertiary cancer center in India.…”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS-related lymphoma: perspective from a regional cancer center in India

et al. 2019

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BackgroundIndia has the third largest population of people living with HIV/AIDS (PLHA). Lymphoma is the second most common malignancy among PLHA. However, data are lacking regarding HIV/AIDS-related lymphoma (ARL) in India. This study evaluated the epidemiology and clinical outcomes of ARL from a regional cancer center in India.MethodsThis retrospective analysis included cases of ARL between March 2011 and September 2017. Data were obtained from patient record files for the assessment of epidemiology and clinical outcomes. Statistical analysis was performed using GraphPad Prism 6. Comparisons of subtype-specific survivals were performed using log-rank tests.ResultsOf 1,226 lymphoma cases, 80 (6.5%) were ARL. Details were available for 70 patients. The median age at diagnosis was 40.5 (9–74) years with a male:female ratio of 2:1. AIDS-defining lymphomas (ADL) constituted 78.6% of cases, while 21.4% had non-AIDS defining lymphoma (NADL). The mean CD4 counts were 193.15±92.85 and 301.93±107.95 cells/µL, respectively (t-test; P=0.0002). Extranodal involvement was present in 55.7%, B symptoms were reported in 60%, and lactate dehydrogenase (LDH) was elevated in 64.3% of patients. The median overall survival times were 6 months for plasmablastic lymphoma (PBL), 23 months for diffuse large B-cell lymphoma (DLBCL), and was not reached for Hodgkin's lymphoma (log-rank test; P=0.0011). Other histological subtype cases were too few to draw meaningful survival outcomes.ConclusionARL is a heterogeneous disease. Histologic subtype is a major determinant of the clinical outcome. ADL has significantly lower CD4 counts than those of NADL. There is an urgent and unmet need for uniform management guidelines for improving outcomes in this under-represented patient population.

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Spectrum of malignancies in human immunodeficiency virus – positive patients at a Tertiary Care Centre in South India

Cited by 5 publications

References 0 publications

Patterns of malignancies in patients with HIV-AIDS: a single institution observational study

Patterns of malignancies in patients with HIV-AIDS: a single institution observational study

Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India

HIV/AIDS-related lymphoma: perspective from a regional cancer center in India

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