title: Cancers in the TREAT Asia HIV Observational Database (TAHOD): a retrospective analysis of risk factors.
abstract: BACKGROUND
  This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer.
  
  
  METHODS
  TREAT Asia HIV Observational Database (TAHOD) sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs), and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR) and unrelated (NADC-IUR).
  
  
  RESULTS
  A total of 617 patients were included in this study: 215 cancer cases and 402 controls from 13 sites. The majority of cancer cases were male (71%). The mean age (SD) for cases was 39 (10.6), 46 (11.5) and 44 (13.7) for ADCs, NADC-IURs and NADCs-IR, respectively. The majority (66%) of cancers were ADCs (16% Kaposi sarcoma, 40% non-Hodgkin's lymphoma, and 9% cervical cancer). The most common NADCs were lung (6%), breast (5%) and hepatocellular carcinoma and Hodgkin's lymphoma (2% each). There were also three (1.4%) cases of leiomyosarcoma reported in this study. In multivariate analyses, individuals with CD4 counts above 200 cells/mm3 were approximately 80% less likely to be diagnosed with an ADC (p < 0.001). Older age (OR: 1.39, p = 0.001) and currently not receiving antiretroviral treatment (OR: 0.29, p = 0.006) were independent predictors of NADCs overall, and similarly for NADCs-IUR. Lower CD4 cell count and higher CDC stage (p = 0.041) were the only independent predictors of NADCs-IR.
  
  
  CONCLUSIONS
  The spectrum of cancer diagnoses in the Asia region currently does not appear dissimilar to that observed in non-Asian HIV populations. One interesting finding was the cases of leiomyosarcoma, a smooth-muscle tumour, usually seen in children and young adults with AIDS, yet overall quite rare. Further detailed studies are required to better describe the range of cancers in this region, and to help guide the development of screening programmes.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW, Australia. kpetoumenos@nchecr.unsw.edu.au
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.forename: Eugenie
authors.initials: E
authors.lastname: Hui
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kerr
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Yi-Ming A
authors.initials: YM
authors.lastname: Chen
authors.forename: Tuti
authors.initials: T
authors.lastname: Merati
authors.forename: Fujie
authors.initials: F
authors.lastname: Zhang
authors.forename: Poh-Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Somnuek
authors.initials: S
authors.lastname: Sungkanuparph
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pujari
authors.forename: Sasheela
authors.initials: S
authors.lastname: Ponnampalavanar
authors.forename: Rosanna
authors.initials: R
authors.lastname: Ditangco
authors.forename: Christopher Kc
authors.initials: CK
authors.lastname: Lee
authors.forename: Andrew
authors.initials: A
authors.lastname: Grulich
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
mesh_terms: D000328:Adult; D001208:Asia / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors