title: Children with cancer and HIV infection: what is different about them?
abstract: BACKGROUND
  Children with HIV and cancer show an excess of non-Hodgkin lymphoma and leiomyosarcoma when compared with children with malignancy but without HIV. This study aimed at: (1) comparing the distribution of various cancers in South African children with malignancies and HIV versus children with malignancies but without HIV and (2) comparing the outcomes after therapy.
  
  
  METHODS
  This is a retrospective comparative study of 84 black children with cancer and HIV, consecutively admitted at Tygerberg Children's Hospital, Cape Town and Universitas Hospital, Bloemfontein, between 1995 and 2010, compared with 570 HIV-negative black children with malignant diseases, consecutively admitted at the 2 hospitals, between 2002 and 2010. Variables studied included age, sex ratio, number of cases of each malignancy, length of follow-up, treatment abandonment, and mortality. The statistical significance was tested with the Student t test and χ test for P≤0.05. Kaplan-Meyer survival curves were constructed.
  
  
  RESULTS
  The most frequent cancer was Kaposi sarcoma (39.3%), seen exclusively in children with HIV. Burkitt lymphoma was found more often (20.2%) in the HIV-positive group than in the HIV-negative one (2.8%, P<0.0001). Leiomyosarcoma, described as the second most frequent neoplasm encountered in HIV-positive children, was found in this series only once. The survival figures are much worse in the HIV-positive group: 26.2% versus 47.7% (P<0.0001), mainly due to drug toxicity.
  
  
  CONCLUSIONS
  Kaposi sarcoma and Burkitt lymphoma occurred more often in children with HIV. These children have a lower tolerance of chemotherapy, even when combined with HAART.
authors.affiliation: *Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Stellenbosch University, Cape Town †Department of Paediatrics and Child Health, Universitas Hospital, University of the Free State, Bloemfontein, South Africa.
authors.forename: Daniela C
authors.initials: DC
authors.lastname: Stefan
authors.forename: David K
authors.initials: DK
authors.lastname: Stones
mesh_terms: D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000821:virology*; D012189:Retrospective Studies; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome