Cancer in cohort of HIV-infected population: prevalence and clinical characteristics.
OBJECTIVE
To determine the incidence and survival time of acquired immunodeficiency syndrome-related malignancies among HIV-infected population.


METHODS
A clinical database search, chart review and verification with health records were undertaken for all AIDS-defining cancers diagnosed in Zhongnan Hospital Wuhan University, Hubei Province, China. Kaplan-Meier method was used to evaluate survival time in HIV-infected patients with cancer.


RESULTS
A total of 3,554 patients with 11,072 person-years of HIV follow-up care were reviewed from January 2004 to December 2008. Sixty-three cancer cases were identified. The median ages of HIV-positive cancer cases were 42.4 ± 8.8 years, CD4 count were 220.9 ± 142.3/µl. The common cancers were non-Hodgkin's lymphoma (NHL, 28.6%), cervical cancer (22.2%), liver cancer (17.5%). Statistically significantly elevated SIRs were observed in NHL (SIR in all = 34.5, 95% CI 11.7-89.9, SIR in males = 45.3, 95% CI 24.7-138.9, females = 12.2, 95% CI 3.9-38.2), invasive cervical cancer (SIR = 68.1, 95% CI 19.2-84.5), liver cancer (SIR = 6.0, 95% CI 2.6-12.2), nasopharyngeal cancer (SIR = 6.2, 95% CI 1.5-44.9), bladder cancer (SIR = 4.9, 95% CI 0.9-22.9), esophageal cancer (SIR = 3.1, 95% CI 0.7-14.3), and stomach cancer (SIR = 2.6, 95% CI 0.6-11.6). All cancers combined showed a statistically significantly elevated SIR of 4.1 (95% CI 2.5-4.6), SIR for all cancers was much higher in female (SIR = 4.8, 95% CI 3.2-7.3) than in male (SIR = 3.1, 95% CI 2.1-4.3). Among HIV-positive patients with cancer, the median survival time was 14.5 ± 3.8 months in NHL group, 28.9 ± 3.6 months in cervix group, 5.1 ± 1.1 months in liver group, and 26.7 ± 6.7 months in other groups. The median survival time in HIV-infected group (23.1 ± 3.5 months) was shorter than that in non-HIV-infected group (43.0 ± 5.1 months), (P < 0.05).


CONCLUSIONS
NHL, cervical cancers and liver cancer are common cancers among HIV-infected individuals in Hubei, China. Most malignant diseases that arise in the setting of HIV infection tend to occur at a more advanced stage with shorter survival time.
Zhang
Yong-xi
YX
Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Donghu Road 169, Wuchang District, Wuhan, Hubei, China. yx.zhang1972@gmail.com
Gui
Xi-en
XE
Zhong
Ya-hua
YH
Rong
Yu-ping
YP
Yan
Ya-jun
YJ
D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology