title: Prevalence and mortality of cancer among HIV-infected inpatients in Beijing, China.
abstract: BACKGROUND
  Cancer is responsible for elevated HIV-related morbidity and mortality. Research on HIV-infected patients with concurrent cancer is rare in China. The purpose of our study was to investigate the prevalence and risk factors associated with cancer among HIV-infected inpatients in Beijing, and to investigate the mortality and risk factors among HIV-infected inpatients with cancer.
  
  
  METHODS
  Hospital records from a total of 1946 HIV-infected patients were collected from the Beijing Ditan Hospital. The data, from 2008 to 2013, were collected retrospectively. The cancer diagnoses included AIDS-defining cancers (ADC) and non-AIDS defining cancers (NADC). Logistic regression was used to identify risk factors predicting the concurrence of cancer with HIV. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models.
  
  
  RESULTS
  7.7 % (149 cases) of all HIV-infected inpatients had concurrent cancer at their first hospital admission; of those, 33.6 % (50 cases) had ADCs, and 66.4 % (99 cases) had NADCs. The most prevalent NADCs were Hodgkin's lymphoma, gastrointestinal cancer, liver cancer, and lung cancer. Patients who did not accept antiretroviral therapy (ART) were more likely to suffer from cancer [AOR = 2.07 (1.42-3.01), p = 0.001]. Kaplan-Meier curves indicated that the survival probability of HIV-positive cancer patients was significantly lower than that of HIV-positive cancer-free patients (log-rank test, p < 0.001). For patients diagnosed with cancer, the mortality was also higher among those who did not receive ART [AHR = 2.19 (1.84-2.61), p < 0.001].
  
  
  CONCLUSIONS
  The prevalence of cancer concurrence among hospitalized HIV-infected patients was 7.7 %. Concurrent cancer also increased mortality among HIV-infected patients. ART was protective against concurrent cancer as well as mortality among HIV-infected cancer patients. These results highlight the importance of promoting cancer screening and early ART initiation among HIV-infected patients.
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Su
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, China. 13911022130@163.com.
authors.forename: Hongxin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: School of Public Health, Yale University, New Haven, CT, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Wang
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jiali
authors.initials: J
authors.lastname: Wang
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, China.
authors.forename: Fujie
authors.initials: F
authors.lastname: Zhang
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. zhaoyan1973@sina.cn.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors