Ontology highlight
ABSTRACT: Background
Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia.Methods
Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier.Results
Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological 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%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy.Conclusions
Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
SUBMITTER: Jiamsakul A
PROVIDER: S-EPMC6375805 | biostudies-literature | 2019 Mar
REPOSITORIES: biostudies-literature
Jiamsakul Awachana A Polizzotto Mark M Wen-Wei Ku Stephane S Tanuma Junko J Hui Eugenie E Chaiwarith Romanee R Kiertiburanakul Sasisopin S Avihingasanon Anchalee A Yunihastuti Evy E Kumarasamy Nagalingeswaran N Ly Penh Sun PS Pujari Sanjay S Ditangco Rossana R Do Cuong Duy CD Merati Tuti Parwati TP Kantipong Pacharee P Zhang Fujie F Van Nguyen Kinh K Kamarulzaman Adeeba A Choi Jun Yong JY Sim Benedict L H BLH Ng Oon Tek OT Ross Jeremy J Wong Wingwai W
Journal of acquired immune deficiency syndromes (1999) 20190301 3
<h4>Background</h4>Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia.<h4>Methods</h4>Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan ...[more]