Epidemiological trends and therapeutic challenges of malignancies in adult HIV-1-infected patients receiving combination antiretroviral therapy in a tertiary hospital from Romania: An observational retrospective study. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: Gheorghiță, Valeriu; Conea, Iuliana F.; Radu, Adelina M.C.; Ștefan, Ion; Mărdărescu, Mariana; Petrea, Sorin; Streinu-Cercel, Adrian
• Is Part Of: Journal of infection and public health. Volume 12:Issue 2(2019)
• Page Start: 182
• Page End: 189
• Publication Date: 2019-03
• Subjects: AIDS Acquired immunodeficiency syndrome -- ADCs AIDS-defining cancers -- cART Combination antiretroviral therapy -- CHTx Cytotoxic chemotherapy -- CMV Cytomegalovirus -- HBsAg Hepatitis B surface antigen -- HBV Hepatitis B virus -- HCV Hepatitis C virus -- HCVAb Antibodies against hepatitis C virus -- HIV Human immunodeficiency virus -- HTX Heterosexual -- HL Hodgkin lymphoma -- KS Kaposi sarcoma -- MSM Men who have sex with men -- NADCs Non-AIDS-defining cancers -- NHL Non-Hodgkin lymphoma -- PLHIV People living with HIV -- PWID People who inject drugs -- RTx Radiotherapy; AIDS -- HIV -- Cancer -- Kaposi sarcoma -- Epidemiology -- Romania; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2018.09.011
• Languages: English
• ISSNs: 1876-0341

Abstract

Abstract: Background: Malignancies have become a leading cause of morbidity and mortality in people living with HIV (PLHIV). The primary endpoint of our study was to describe the epidemiology of acquired immunodeficiency syndrome (AIDS)-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). Epidemiological disparities, mortality predictors and survival analysis within the two groups of patients were key secondary endpoints. Methods: We retrospectively evaluated all adult PLHIV with histopathologically proven cancers registered from 2010 to 2016 in the "Matei Balș" National Institute for Infectious Diseases, Bucharest, Romania. Results: 110 eligible patients have been included in the study. The incidence of ADCs decreased from 1.6% in 2010 to 0.3% in 2016, unlike NADCs which remained fairly stable over time (0.3%). The higher CD4 count and lower HIV-RNA level at the cancer diagnosis were associated with prolonged survival in ADCs group, but not in NADCs group. The mean CD4 count was 449/mm 3 to survivors and 92/mm 3 to non-survivors (p = 0.017). The mean level of HIV-RNA was 64, 671 copies/mL to survivors and 1, 760, 345 copies/mL to non-survivors (p = 0.002). Conclusions: A good therapeutic control of HIV infection at the diagnosis of ADCs was associated with better survival, emphasizing the key role of the effective cART in the management of HIV-associated cancers.