Epidemiological trends and therapeutic challenges of malignancies in adult HIV-1-infected patients receiving combination antiretroviral therapy in a tertiary hospital from Romania: An observational retrospective study

J Infect Public Health. 2019 Mar-Apr;12(2):182-189. doi: 10.1016/j.jiph.2018.09.011. Epub 2018 Oct 19.

Abstract

Background: Malignancies have become a leading cause of morbidity and mortality in people living with HIV (PLHIV). The primary endpoint of our study was to describe the epidemiology of acquired immunodeficiency syndrome (AIDS)-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). Epidemiological disparities, mortality predictors and survival analysis within the two groups of patients were key secondary endpoints.

Methods: We retrospectively evaluated all adult PLHIV with histopathologically proven cancers registered from 2010 to 2016 in the "Matei Balș" National Institute for Infectious Diseases, Bucharest, Romania.

Results: 110 eligible patients have been included in the study. The incidence of ADCs decreased from 1.6% in 2010 to 0.3% in 2016, unlike NADCs which remained fairly stable over time (0.3%). The higher CD4 count and lower HIV-RNA level at the cancer diagnosis were associated with prolonged survival in ADCs group, but not in NADCs group. The mean CD4 count was 449/mm3 to survivors and 92/mm3 to non-survivors (p=0.017). The mean level of HIV-RNA was 64,671 copies/mL to survivors and 1,760,345 copies/mL to non-survivors (p=0.002).

Conclusions: A good therapeutic control of HIV infection at the diagnosis of ADCs was associated with better survival, emphasizing the key role of the effective cART in the management of HIV-associated cancers.

Keywords: AIDS; Cancer; Epidemiology; HIV; Kaposi sarcoma; Romania.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / pathology
  • HIV Infections / virology
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Neoplasms / mortality
  • Retrospective Studies
  • Romania / epidemiology
  • Survival Analysis
  • Tertiary Care Centers
  • Viral Load

Substances

  • Anti-Retroviral Agents