Abstract
HIV-associated malignancies are responsible for morbidity and mortality increasingly in the era of potent antiretroviral therapy. This study aimed to investigate the distribution of HIV-associated malignancies among inpatients, the immunodeficiency and the effect of antiretroviral therapy (ART) on spectrum of HIV-associated malignancies. A total of 438 cases were enrolled from 2007 to 2020 in Beijing Ditan Hospital. Demographic, clinical and laboratory data, managements, and outcomes were collected and analyzed retrospectively. Of 438 cases, 433 were assigned to non-AIDS-defining cancers (NADCs) (n = 200, 45.7%) and AIDS-defining cancers (ADCs) (n = 233, 53.2%), 5 (1.1%) with lymphoma were not specified further. No significant change was observed in the proportion of NADCs and ADCs as time goes on. Of NADCs, lung cancer (n = 38, 19%) was the most common type, followed by thyroid cancer (n = 17, 8.5%). Patients with ADCs had lower CD4 counts(104.5/μL vs. 314/μL), less suppression of HIVRNA(OR 0.23, 95%CI 0.16–0.35) compared to those with NADCs. ART did not affect spectrum of NADCs, but affect that of ADCs (between patients with detectable and undetectable HIVRNA). ADCs remain frequent in China, and NADCs play an important role in morbidity and mortality of HIV positive population.
Highlights
Human immunodeficiency virus (HIV)-associated malignancies are responsible for morbidity and mortality increasingly in the era of potent antiretroviral therapy
The availability of protease inhibitors ushered in era of potent combined antiretroviral therapy since 1996. cART leads to immune restoration by suppression of HIV viral replication and normalization of CD4 lymphocyte which could decrease the incidence of opportunistic infections and risk of development of Kaposi’s sarcoma (KS) and some types of non-Hodgkin lymphoma (NHL)
As the incidence of those malignancies has decrease substantially with the wide use of cART9, a relative increase of non-acquired immunodeficiency syndrome (AIDS)-defining cancers (NADCs) were observed in HIV positive population compared with the general population, including Hodgkin lymphoma, melanoma, liver, lung, oropharyngeal, and colorectal cancers[10,11,12,13]
Summary
HIV-associated malignancies are responsible for morbidity and mortality increasingly in the era of potent antiretroviral therapy. HIV-associated malignancies refer to a wide range of cancers with increased incidence in HIV-positive population, including AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). CART leads to immune restoration by suppression of HIV viral replication and normalization of CD4 lymphocyte which could decrease the incidence of opportunistic infections and risk of development of KS and some types of NHL. As the incidence of those malignancies has decrease substantially with the wide use of cART9, a relative increase of NADCs were observed in HIV positive population compared with the general population, including Hodgkin lymphoma, melanoma, liver, lung, oropharyngeal, and colorectal cancers[10,11,12,13]. There have been limited published studies about HIV-associated malignancies available in China
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