TY - JOUR
T1 - Brief Report
T2 - Malignancies in Adults Living with HIV in Asia
AU - Jiamsakul, Awachana
AU - Polizzotto, Mark
AU - Wen-Wei Ku, Stephane
AU - Tanuma, Junko
AU - Hui, Eugenie
AU - Chaiwarith, Romanee
AU - Kiertiburanakul, Sasisopin
AU - Avihingasanon, Anchalee
AU - Yunihastuti, Evy
AU - Kumarasamy, Nagalingeswaran
AU - Ly, Penh Sun
AU - Pujari, Sanjay
AU - Ditangco, Rossana
AU - Do, Cuong Duy
AU - Merati, Tuti Parwati
AU - Kantipong, Pacharee
AU - Zhang, Fujie
AU - Van Nguyen, Kinh
AU - Kamarulzaman, Adeeba
AU - Choi, Jun Yong
AU - Sim, Benedict L.H.
AU - Ng, Oon Tek
AU - Ross, Jeremy
AU - Wong, Wingwai
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background:Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia.Methods:Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier.Results:Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/μL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/μL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/μL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy.Conclusions:Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
AB - Background:Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia.Methods:Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier.Results:Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/μL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/μL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/μL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy.Conclusions:Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
KW - Asia
KW - HIV
KW - cancer
KW - lymphoma
KW - resource-limited
UR - http://www.scopus.com/inward/record.url?scp=85061481888&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000001918
DO - 10.1097/QAI.0000000000001918
M3 - Article
C2 - 30531303
AN - SCOPUS:85061481888
SN - 1525-4135
VL - 80
SP - 301
EP - 307
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -
