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Infect Agent Cancer. 2018 May 8;13:16. doi: 10.1186/s13027-018-0188-3. eCollection 2018.

Survival after cancer diagnosis in a cohort of HIV-positive individuals in Latin America.

Author information

1
Fundación Huésped, Pasaje Gianantonio 3932, C1202ABB Buenos Aires, Argentina.
2
2Vanderbilt University School of Medicine, 1161 21st Ave. S A2200 Medical Center North, Nashville, TN 37232 USA.
3
3Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, RJ 21040-900 Brasil.
4
4Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán: Unidad del Paciente Ambulatorio (UPA), 5to piso Vasco de Quiroga # 15 Col. Sección XVI Delegación Tlalpan; C.P, 14000 Mexico City, Mexico.
5
Fundación Arriarán, Santa Elvira 629, Santiago, Chile.
6
Instituto Hondureño de Seguridad Social, Barrio la Granja, Tegucigalpa Honduras, Hospital Escuela Universitario: Av La Salud, Tegucigalpa, Honduras.

Abstract

Background:

This study aimed to evaluate trends and predictors of survival after cancer diagnosis in persons living with HIV in the Caribbean, Central, and South America network for HIV epidemiology cohort.

Methods:

Demographic, cancer, and HIV-related data from HIV-positive adults diagnosed with cancer ≤ 1 year before or any time after HIV diagnosis from January 1, 2000-June 30, 2015 were retrospectively collected. Cancer cases were classified as AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC). The association of mortality with cancer- and HIV-related factors was assessed using Kaplan-Meier curves and Cox proportional hazards models stratified by clinic site and cancer type.

Results:

Among 15,869 patients, 783 had an eligible cancer diagnosis; 82% were male and median age at cancer diagnosis was 39 years (interquartile range [IQR]: 32-47). Patients were from Brazil (36.5%), Argentina (19.9%), Chile (19.7%), Mexico (19.3%), and Honduras (4.6%). A total of 564 ADC and 219 NADC were diagnosed. Patients with NADC had similar survival probabilities as those with ADC at one year (81% vs. 79%) but lower survival at five years (60% vs. 69%). In the adjusted analysis, risk of mortality increased with detectable viral load (adjusted hazard ratio [aHR] = 1.63, p = 0.02), age (aHR = 1.02 per year, p = 0.002) and time between HIV and cancer diagnoses (aHR = 1.03 per year, p = 0.01).

Conclusion:

ADC remain the most frequent cancers in the region. Overall mortality was related to detectable viral load and age. Longer-term survival was lower after diagnosis of NADC than for ADC, which may be due to factors unrelated to HIV.

KEYWORDS:

AIDS defining cancer; Cancer; Cohort studies; HIV; Latin America; Non AIDS defining cancer; Survival

Conflict of interest statement

Institutional Ethics Review Boards from all sites (IRB00002014- Comité de Bioética Fundación Huésped IRB -Argentina-; IRB00004170- Comite - CEP IPEC -Brazil-; IRB00011115- Comité Ético Científico Servicio de Salud Metropolitano Central IRB–Chile-, IRB00003070- Unidad de Investigacion Cientifica IRB – Biomedical–Honduras-, IRB00001910- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran IRB -Mexico) and IRB00000475- Vanderbilt University Health Science Committee IRB - approved the project, waiving the requirement for individual patient informed consent.The authors declare that they have no conflicts of interest.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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