Abstract
BackgroundCancer is responsible for elevated HIV-related morbidity and mortality. Research on HIV-infected patients with concurrent cancer is rare in China. The purpose of our study was to investigate the prevalence and risk factors associated with cancer among HIV-infected inpatients in Beijing, and to investigate the mortality and risk factors among HIV-infected inpatients with cancer.MethodsHospital records from a total of 1946 HIV-infected patients were collected from the Beijing Ditan Hospital. The data, from 2008 to 2013, were collected retrospectively. The cancer diagnoses included AIDS-defining cancers (ADC) and non-AIDS defining cancers (NADC). Logistic regression was used to identify risk factors predicting the concurrence of cancer with HIV. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models.Results7.7 % (149 cases) of all HIV-infected inpatients had concurrent cancer at their first hospital admission; of those, 33.6 % (50 cases) had ADCs, and 66.4 % (99 cases) had NADCs. The most prevalent NADCs were Hodgkin’s lymphoma, gastrointestinal cancer, liver cancer, and lung cancer. Patients who did not accept antiretroviral therapy (ART) were more likely to suffer from cancer [AOR = 2.07 (1.42–3.01), p = 0.001]. Kaplan-Meier curves indicated that the survival probability of HIV-positive cancer patients was significantly lower than that of HIV-positive cancer-free patients (log-rank test, p < 0.001). For patients diagnosed with cancer, the mortality was also higher among those who did not receive ART [AHR = 2.19 (1.84–2.61), p < 0.001].ConclusionThe prevalence of cancer concurrence among hospitalized HIV-infected patients was 7.7 %. Concurrent cancer also increased mortality among HIV-infected patients. ART was protective against concurrent cancer as well as mortality among HIV-infected cancer patients. These results highlight the importance of promoting cancer screening and early ART initiation among HIV-infected patients.
Highlights
Cancer is responsible for elevated HIV-related morbidity and mortality
Our hypothesis was that antiretroviral therapy (ART) was protective against concurrent cancer as well as cancer-related mortality among HIV-infected patients
We aimed to identify the risk factors associated with concurrent cancer among People living with HIV/AIDS (PLWHA) and risk factors associated with mortality among PLWHA with cancer
Summary
Cancer is responsible for elevated HIV-related morbidity and mortality. Research on HIV-infected patients with concurrent cancer is rare in China. People living with HIV/AIDS (PLWHA) are at higher risk of developing concurrent cancer due to the impairment of the immune system [1]. Cancer is in turn responsible for increased HIV-related morbidity and mortality [2, 3]. Evidence reveals that risk of ADCs has been dropping among HIV/AIDS patients since 1996 [6]. ART has been reported to be effective in lowering the risk of opportunistic infection and treating cancer-related diseases [8,9,10], evidence for the efficacy
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