Clinical Characteristics and Outcomes of HIV-Infected Patients with Non-AIDS Defining Cancers in a National Institute Cancer in Mexico

Abstract

Background Non-AIDS Defining Cancers (NADCs) have been recognized as an increasing cause of morbidity and mortality in HIV patients, related mainly to co-infections and/or lifestyle risks. There is no data of NADCs prevalence in Mexico. We describe type of NADCS, clinical characteristics and outcomes of HIV-infected individuals with NADCs.Methods We conducted a retrospective study of 1126 patients attending the HIV/AIDS Clinic at Instituto Nacional de Cancerología in Mexico city (a tertiary care center for adult patients with cancer), since 1996 to December 2016, who had confirmed NADCs after HIV diagnosis. Demographic and clinical data were collected for all HIV patients with NADCs.ResultsOver 1126 HIV-positive individuals seen at the INCan, 139 (12.3%) patients developed a NADC, five patients developed two NADCs during their follow-up, 114 (82%) were male. The median age at diagnosis of NADCs was 42.4 ± 10.9 years, the median of CD4 was 354.4 cell/mm at that time of NADCs, 81 of them (56.3%) had a CD4 count >200 cell/mm3, 81 (56.3%) had undetectable HIV viral load. In males the distribution of NADCS was 36 (25%) Hodgkin’s lymphoma (HL), 16 (11.1%) anal cancer, 13 (9%) germinal tumors males, and two lung cancers, and in females: 11 (7.7%) vulvo-vaginal, seven (4.9%) breast cancer, four (2.8%) thyroid cancer and one case of Hodgkin’s lymphoma. The median of follow-up of NADCs was 2.5 (IQR 0.4,3.6) years. Nine patients died attributable to NADCs and 51 patients lost of follow-up.Conclusion HL was the most frequent NADC on men as it has been described in other reports, followed by anal cancer. In women vulvo-vaginal cancers were the most frequent. These three malignances are related with viral etiology. Lung cancer was uncommon, different from that described in the US population, smoking is less frequent in the HIV Mexican population. NADCS can occur at any stage of HIV infection, regardless of immune status.Disclosures All authors: No reported disclosures.