AIDS-associated cancers: an emerging challenge.
OBJECTIVE
To study the incidence and effects of anti-retroviral therapy along with cancer chemotherapy on outcome of AIDS associated Cancers in Indian patients.


METHODS
3832 cancers patients were investigated over a period of 5 years. 46 AIDS-associated cancers were identified. HIV status was evaluated by ELISA, Western Blot, viral load and CD4/CD8 counts. Patients were treated with different modalities of cancer management and anti-retroviral therapy was discussed with the patient and relatives. Patients were followed up 6 monthly.


RESULTS
Incidence of AIDS-associated cancers was 1.2 percent. AIDS-Defining Cancers (ADC) were seen in 26 (54.35%) while non-AIDS-Defining Cancers (NADC) were observed in 21 (45.65%). Non Hodgkin Lymphoma was the commonest form of AIDS-defining cancers in 21 (84%) patients, cervical cancers in 4 (16%) women while there was not a single case of Kaposi's Sarcoma. AIDS associated cancers were common in males. Mean age was 38.5 years. Only 33.5% patients received treatment for HIV and cancers. Development of immune reconstitution syndrome was observed in 9.09% patients. Hepatitis B infection was seen in only one patient (2.17%).


CONCLUSIONS
AIDS-associated cancers are seen in advanced stage of HIV infection. Concurrent chemotherapy and anti-retroviral therapy for ARL is significantly effective. Cervical cancers and non-AIDS-defining cancers do not show predictable response to anti-retroviral therapy. Mortality in non-AIDS related cancers was significantly higher than AIDS related cancers.
Phatak
Uday A
UA
Department of General Medicine, Shri Siddhi Vinayak Ganapati Cancer Hospital, Miraj.
Joshi
Ravindra
R
Badakh
Dinesh K
DK
Gosavi
Vikas S
VS
Phatak
Jayanti U
JU
Jagdale
Rakhi V
RV
D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D017678:Sex Distribution; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D055815:Young Adult
D044966:Anti-Retroviral Agents