Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/63701
Title: Brief Report: Malignancies in Adults Living With HIV in Asia
Authors: Awachana Jiamsakul
Mark Polizzotto
Stephane Wen-Wei Ku
Junko Tanuma
Eugenie Hui
Romanee Chaiwarith
Sasisopin Kiertiburanakul
Anchalee Avihingasanon
Evy Yunihastuti
Nagalingeswaran Kumarasamy
Penh Sun Ly
Sanjay Pujari
Rossana Ditangco
Cuong Duy Do
Tuti Parwati Merati
Pacharee Kantipong
Fujie Zhang
Kinh Van Nguyen
Adeeba Kamarulzaman
Jun Yong Choi
Benedict L.H. Sim
Oon Tek Ng
Jeremy Ross
Wingwai Wong
Keywords: Medicine
Issue Date: 1-Mar-2019
Abstract: BACKGROUND: Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS: Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier. RESULTS: Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy. CONCLUSIONS: Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061481888&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/63701
ISSN: 19447884
Appears in Collections:CMUL: Journal Articles

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