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Patterns of malignancies in patients with HIV-AIDS: a single institution observational study

The Journal of Community and Supportive Oncology. 2018 October;16(5):e188-e192 | 10.12788/jcso.0416
November 27, 2018|Hematology and Oncology
Koppaka et al
Author and Disclosure Information

Rudresha A Haleshappa, DM,a Deepak Koppaka, MD,a Kuntegowdanahalli C Lakshmaiah, MD, DM,a Kanakasetty B Govind, MD, DM,a Lokanatha Dasappa, MD, DM,a Chennagiri Premalata, MD,b Linu A Jacob, DM,a Babu MC Suresh, MD, DM,a Basappa Gurusidappa Sumathi, MD,c Kadabur N Lokesh, MD, DM,a Lakkavalli Krishnappa Rajeev, DM,a Smitha C Saldanha, MD, DM,a Anand Abhishek, MD,a Nikita J Mulchandani, MD,b and Vikas Asati, MDa

Departments of aMedical Oncology, bPathology, and cMicrobiology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India

Background With the widespread use of antiretroviral therapy in patients with HIV-AIDS, a prolonged life expectancy is now evident. This has led to an increased incidence of malignancies in this patient population. The spectrum of malignancies in these patients differs worldwide.

Objective To study the patterns of AIDS-defining malignancies (ADMs) and non–AIDS-defining malignancies (NADMs) in patients in India with HIV-AIDS and to analyze the correlation of CD4 counts with the malignancies.

Methods This retrospective study included patients presenting with a malignancy and coexisting HIV-AIDS from January 2013 through December 2016. Patients with CD4 counts at the time of diagnosis of malignancy and having received treatment were analyzed. Analyses of the patient characteristics and correlation of CD4 counts with ADM and NADM were performed.

Results A total of 285 patients were evaluated. The median age was 44.8 years (range, 5-80 years). The mean CD4 count was 235.4 cells/mm3 (range, 50-734 cells/mm3; reference range, 500-1,500 cells/mm3). Cervical cancer was the most common malignancy in women, and non-Hodgkin lymphoma (NHL) was the most common among men. There was a statistically significant difference in CD4 counts between ADMs and NADMs (P = .03). A statistical difference was also noted when the CD4 counts of patients with NHL were compared with other malignancies. However, there was no statistically significant difference noted when CD4 counts of patients with cervical cancer were compared with NADM (P = .914).

Limitations This was a retrospective study and included only patients receiving treatment for malignancies at a single institution.

Conclusions NHL and cervical cancer continue to be the most common malignancies in patients with HIV-AIDS in developing countries. NHL tends to occur in patients with lower CD4 counts.

Funding/sponsorship None

 

Accepted for publication August 13, 2018
Correspondence
Deepak Koppaka, MD; Drdeepak.Koppaka@gmail.com
Disclosures The authors report no disclosures/conflicts of interest.
Citation JCSO 2018;16(4):e188-e192

©2018 Frontline Medical Communications
doi https://doi.org/10.12788/jcso.0416

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Conclusions

With the wide use of HAART by patients with HIV-AIDS, we can expect an increase in the survival of that population. The incidence of malignancies may also increase significantly in these patients, and further longitudinal studies are needed, as malignancies may emerge as the most common cause of death in patients with HIV-AIDS. In addition, the extensive use of HAART therapy and implementation of screening programs for cervical cancer in patients with HIV-AIDS could result in a decrease in the incidence of ADMs.

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