title: Bladder Cancer in HIV-infected Adults: An Emerging Issue? Case-Reports and Systematic Review.
abstract: OBJECTIVE
  Non-AIDS-related malignancies now represent a frequent cause of death among HIV-infected patients. Albeit bladder cancer is one of the most common malignancies worldwide, it has been rarely reported among HIV-infected patients. We wished to assess the prevalence and characteristics of bladder cancer in HIV-infected patients.
  
  
  METHODS
  We conducted a single center retrospective study from 1998 to 2013 in a university hospital in Paris. Cases of bladder cancer among HIV-infected patients were identified using the electronic records of the hospital database and of the HIV-infected cohort. Patient characteristics and outcomes were retrieved from patients charts. A systematic review of published cases of bladder cancers in patients with HIV-infection was also performed.
  
  
  RESULTS
  During the study period we identified 15 HIV-infected patients (0.2% of the cohort) with a bladder cancer. Patients were mostly men (73%) and smokers (67%), with a median age of 56 years at cancer diagnosis. Bladder cancer was diagnosed a median of 14 years after HIV-infection. Most patients were on ART (86%) with median current and nadir CD4 cell counts of 506 and 195 cells/mm3, respectively. Haematuria (73%) was the most frequent presenting symptom and HPV-associated lesions were seen in 6/10 (60%) patients. Histopathology showed transitional cell carcinoma in 80% and a high proportion of tumors with muscle invasion (47%) and high histologic grade (73%). One-year survival rate was 74.6%. The systematic review identified 13 additional cases of urothelial bladder cancers which shared similar features.
  
  
  CONCLUSIONS
  Bladder cancers in HIV-infected patients remain rare but may occur in relatively young patients with a low nadir CD4 cell count, have aggressive pathological features and can be fatal.
authors.affiliation: Department of Infectious Diseases, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Chawki
authors.affiliation: Department of Urology, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: Department of Biostatistic and Medical Information, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Montlahuc
authors.affiliation: Department of Pathology, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Verine
authors.affiliation: Department of Urology, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Mongiat-Artus
authors.affiliation: Department of Urology, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Desgrandchamps
authors.affiliation: Department of Infectious Diseases, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot, Paris 7, Sorbonne Paris Cité, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
mesh_terms: D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D015497:HIV-1; D006417:Hematuria / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology