Cancer in HIV-infected persons from the caribbean, central and South America

Valeria I. Fink, Bryan E. Shepherd, Carina Cesar, Alejandro Krolewiecki, Firas Wehbe, Claudia P. Cortés, Brenda Crabtree Ramírez, Denis Padgett, Maryam Shafaee, Mauro Schechter, Eduardo Gotuzzo, Melanie Bacon, Catherine McGowan, Pedro Cahn, Daniel Masys

    Research output: Contribution to journalArticle

    10 Citations (Scopus)

    Abstract

    Background: HIV-infected individuals have heightened cancer risk. With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS-defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied. Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases. Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed >1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = <0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 person-years of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation. Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.

    Original languageEnglish (US)
    Pages (from-to)467-473
    Number of pages7
    JournalJournal of Acquired Immune Deficiency Syndromes
    Volume56
    Issue number5
    DOIs
    StatePublished - Apr 15 2011

    Fingerprint

    Central America
    South America
    HIV
    Highly Active Antiretroviral Therapy
    Neoplasms
    Acquired Immunodeficiency Syndrome
    Incidence

    Keywords

    • Caribbean
    • HIV
    • Latin America
    • cohort studies
    • neoplasms

    ASJC Scopus subject areas

    • Infectious Diseases
    • Pharmacology (medical)

    Cite this

    Fink, Valeria I. ; Shepherd, Bryan E. ; Cesar, Carina ; Krolewiecki, Alejandro ; Wehbe, Firas ; Cortés, Claudia P. ; Ramírez, Brenda Crabtree ; Padgett, Denis ; Shafaee, Maryam ; Schechter, Mauro ; Gotuzzo, Eduardo ; Bacon, Melanie ; McGowan, Catherine ; Cahn, Pedro ; Masys, Daniel. / Cancer in HIV-infected persons from the caribbean, central and South America. In: Journal of Acquired Immune Deficiency Syndromes. 2011 ; Vol. 56, No. 5. pp. 467-473.
    @article{82149c41da584a1bbc84d26298af3b16,
    title = "Cancer in HIV-infected persons from the caribbean, central and South America",
    abstract = "Background: HIV-infected individuals have heightened cancer risk. With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS-defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied. Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases. Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45{\%} of ADC were diagnosed >1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = <0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4{\%} ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 person-years of follow-up was 7.2 per 1000 person-years (95{\%} confidence interval = 5.5 to 9.3) for ADC and 2.7 (95{\%} confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation. Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.",
    keywords = "Caribbean, HIV, Latin America, cohort studies, neoplasms",
    author = "Fink, {Valeria I.} and Shepherd, {Bryan E.} and Carina Cesar and Alejandro Krolewiecki and Firas Wehbe and Cort{\'e}s, {Claudia P.} and Ram{\'i}rez, {Brenda Crabtree} and Denis Padgett and Maryam Shafaee and Mauro Schechter and Eduardo Gotuzzo and Melanie Bacon and Catherine McGowan and Pedro Cahn and Daniel Masys",
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    Fink, VI, Shepherd, BE, Cesar, C, Krolewiecki, A, Wehbe, F, Cortés, CP, Ramírez, BC, Padgett, D, Shafaee, M, Schechter, M, Gotuzzo, E, Bacon, M, McGowan, C, Cahn, P & Masys, D 2011, 'Cancer in HIV-infected persons from the caribbean, central and South America', Journal of Acquired Immune Deficiency Syndromes, vol. 56, no. 5, pp. 467-473. https://doi.org/10.1097/QAI.0b013e31820bb1c3

    Cancer in HIV-infected persons from the caribbean, central and South America. / Fink, Valeria I.; Shepherd, Bryan E.; Cesar, Carina; Krolewiecki, Alejandro; Wehbe, Firas; Cortés, Claudia P.; Ramírez, Brenda Crabtree; Padgett, Denis; Shafaee, Maryam; Schechter, Mauro; Gotuzzo, Eduardo; Bacon, Melanie; McGowan, Catherine; Cahn, Pedro; Masys, Daniel.

    In: Journal of Acquired Immune Deficiency Syndromes, Vol. 56, No. 5, 15.04.2011, p. 467-473.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Cancer in HIV-infected persons from the caribbean, central and South America

    AU - Fink, Valeria I.

    AU - Shepherd, Bryan E.

    AU - Cesar, Carina

    AU - Krolewiecki, Alejandro

    AU - Wehbe, Firas

    AU - Cortés, Claudia P.

    AU - Ramírez, Brenda Crabtree

    AU - Padgett, Denis

    AU - Shafaee, Maryam

    AU - Schechter, Mauro

    AU - Gotuzzo, Eduardo

    AU - Bacon, Melanie

    AU - McGowan, Catherine

    AU - Cahn, Pedro

    AU - Masys, Daniel

    PY - 2011/4/15

    Y1 - 2011/4/15

    N2 - Background: HIV-infected individuals have heightened cancer risk. With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS-defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied. Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases. Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed >1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = <0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 person-years of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation. Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.

    AB - Background: HIV-infected individuals have heightened cancer risk. With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS-defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied. Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases. Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed >1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = <0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 person-years of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation. Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.

    KW - Caribbean

    KW - HIV

    KW - Latin America

    KW - cohort studies

    KW - neoplasms

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