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

9 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

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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.
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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.",
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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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