title: Spectrum of malignancies among HIV-infected patients in South India.
abstract: BACKGROUND
  The current study examines the spectrum of malignancies among HIV-infected South Indians enrolled in a clinical care program.
  
  
  METHODS
  We conducted a nested matched case-control study among 42 HIV-infected cases who developed cancer and 82 HIV-infected controls between 1998 and 2008 at a tertiary care HIV care program in South India.
  
  
  RESULTS
  The most common types of cancer included non-Hodgkin's lymphoma (38.1%), Hodgkin's lymphoma (16.7%), squamous cell carcinoma (14.3%), and adenocarcinoma (14.3%). The median duration of time from HIV infection to cancer diagnosis was 549 days [interquartile range (IQR): 58-2013]. The nadir CD4 cell count was significantly lower in cases compared to controls (134 cells/μl vs. 169 cells/μl; P = 0.015). Cancer patients were more likely to have a more advanced HIV disease stage at the time of cancer diagnosis compared to control patients (Stage C: 90.5% vs. 49.4%; P<0.0001). Significantly more cancer patients were receiving antiretroviral treatment relative to control patients at the time of cancer diagnosis (92.9% vs. 66.3%; P=0.001).
  
  
  CONCLUSIONS
  HIV-infected patients who developed cancer had more advanced immunodeficiency at the time of cancer diagnosis and a lower nadir CD4 cell count. It is possible that with the continued roll-out of highly active antiretroviral therapy in India, the incidence of HIV-associated malignancies will decrease.
authors: Division of Infectious Diseases, Department of Medicine and Community Health, Alpert Medical School, Brown University/Miriam Hospital, RI, USA.
authors: K K
authors: KK
authors: Venkatesh
authors: S
authors: S
authors: Saghayam
authors: B
authors: B
authors: Devaleenal
authors: S
authors: S
authors: Poongulali
authors: T P
authors: TP
authors: Flanigan
authors: K H
authors: KH
authors: Mayer
authors: N
authors: N
authors: Kumarasamy
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000453:epidemiology; D000328:Adult; D018791:CD4 Lymphocyte Count; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006689:Hodgkin Disease / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007194:India; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged