Diferencias en supervivencia según el tipo de cáncer y el grado de inmunodeficiencia en pacientes con infección VIH

Abstract

Background and objectiveAfter the introduction of antiretroviral therapy, a decrease in AIDS defining cancers (ADCs) is observed, while non-AIDS-defining cancers (NADCs) have increased in HIV-infected patients (HIP). We have little information about the prognosis and associated risk factors. We studied survival and its relationship with immunodeficiency after the diagnosis of ADC or NADC. Material and methodsObservational, retrospective study of 788 HIP of whom 133 developed a malignancy between 2000-2016. Malignancies were divided into ADCs or NADCs and degree of immunodeficiency according to the CD4 T lymphocyte count> or </=200/mm3. Survival was estimated according to the Kaplan Meier method, multivariate COX regression analysis and compared with the log-rank test. Results149 malignancies were diagnosed in 133 HIP: 41.4% ADCs and 58.6 NADCs. The most frequent tumour was NHL (21.1%), followed by lung carcinoma (15%). HCV was positive in 50.4% and 65.4% were smokers. Thirty-nine point one percent had a CD4 T lymphocyte count </=200/mm3, being 60% in the case of ADCs while in NADCs it was 38.5%. CD4 T lymphocyte count </=200/mm3 is significantly associated with lower survival after diagnosis of ADCs(p=.031) and NADCs (p=.005). ConclusionsThe most frequent types of tumours in HIP differ from those in the general population, probably due to oncogenic risk factors. CD4 T lymphocyte count </=200/mm3 is a risk factor related to worse prognosis after NADC or ADC diagnosis.