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AIDS DEFINING AND NON-DEFINING CANCERS IN PERSONS LIVING
WITH HIV IN A SINGLE CENTER COHORT FOLLOWED SINCE 1986
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EACS 2019 Nov 6-9 Basel
Reported by Jules Levin
R. Montejano1, B. Alejos2 , J.I. Bernardino1 , R. De Miguel Buckley1, L. Martin-Carbonero1, C. Busca1, R. Mican1, M.L. Montes1, I. Perez-Valero1, V. Moreno1, J. Gonzalez-Garcia1, J.R. Arribas1, E. Valencia1
1Hospital Universitario La Paz - IdiPAZ, Madrid, Spain, 2Instituto de Salud Carlos III, Madrid, Spain
Program Abstract
Purpose: to review AIDS-defining cancer (ADCs) and non-AIDS-defining cancer (NADCs) and temporal changes in the ADCs/NADCs ratio, in a large single center cohort.
Patients and methods: 5411 HIV-infected participants followed-up between 1986-2018. Data were collected from our clinical database. ADCs and NADCs were defined according to the CDC classification.
Results: We diagnosed 643 patients with at least one malignancy. Patients with NADCs were older and mostly male. (Table1) HIV infection and cancer were simultaneously diagnosed in 21.3%, more frequently in the ADCs group 34.7% vs. 8.07% (p< 0.001). Cancers were diagnosed as clinically advanced in 86 participants (13.4%), similarly distributed between groups, 10.9% ADCs vs 15.7% NADCs. The most frequent cancers were: cervix cancer (134, 20.8%), Kaposi sarcoma (132, 20.53%), non-Hodgkin lymphoma (52, 8.09%), Hodgkin lymphoma (43, 6.7%), hepatocellular carcinoma (32, 4.9%), anal cancer (30, 4.67%), head and neck tumor (27, 4.2%) and lung cancer (25, 3.9%).
NADCs increased over time resulting in a decrease in the ADCs/NADCs ratio with calendar year. (Figure 1) In the late ART period (>2006) NADCs were more frequent (65.6%) than ADCs, (p< 0.001). (Table 2) In 2018, 25/30 (75%) were NADCs, being the most frequent hepatocellular carcinoma (5/25) and lung cancer (4/25). Overall, 430 (66.8%) cancers were related to oncogenic viruses: 166/430 human papillomavirus, 232/430 herpes virus 8 and EBV and 32/430 HBV and/or HCV.
Among 643 patients, 101 (15.9%) patients died due to cancer progression, with higher mortality in NADCs 25.3% vs ADCs 10.6% (p< 0.001). Higher mortality was observed in pancreas (90%), lung (68%) and colon (60%) cancer.
Conclusion:
NADCs increased over the time, being more frequent during the late ART period and with higher mortality. A malignancy was, in an important number of cases, the first manifestation of HIV infection. A significant proportion of cancers were related with oncogenic virus coinfection.
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