Human immunodeficiency virus-associated adenocarcinoma of the colon: clinicopathologic findings and outcome (original) (raw)
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Cancer in HIV-Infected Persons From the Caribbean, Central and South America
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2011
Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed .1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = ,0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 personyears of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation.
Cancer Control
The introduction of antiretroviral therapy (ART) in 1995 had a dramatic impact on the morbidity and mortality of the HIV population, and subsequently, the natural history of cancer has changed. The purpose of our study was to review the prevalence of AIDS-defining malignancies and non-AIDS defining cancers (NADC), taking into consideration racial and gender variations. After the institutional review board approval, the study was conducted as a retrospective chart review of 279 HIV-infected patients who were treated at the Moffitt Cancer Center between January 1, 2000 and December 31, 2010. The demographic characteristics included gender, ethnicity, race, presence or absence of ART, and the type of malignancy reviewed. Of 233 men, 78 (33.5%) had AIDS-defining malignancies. AIDS-related non-Hodgkin lymphoma (NHL) was detected in 49 (21%) patients and Kaposi sarcoma (KS) in 29 (12%) patients. Two-thirds of male patients had NADC, with anal cancer being the most prevalent (8.5%), follow...
2007
Highly active antiretroviral therapy (HAART) has dramatically reduced the incidence of acquired immunodeficiency syndrome (AIDS) and increased AIDS survival time, but little is known about its impact on cancer. Data from adults in the San Francisco, California, AIDS surveillance registry were computer matched with the California Cancer Registry. Age-, sex-, and race-adjusted standardized incidence ratios (SIRs) were computed, and proportional hazards models evaluated the effect of HAART use on cancer incidence and cancer survival time. Among 14,210 adults with AIDS diagnosed in 1990-2000, 482 non-AIDS-defining cancers were diagnosed. Compared with rates for the general population, significantly increased cancer incidence rates were observed for anal (SIR ¼ 13.4), Hodgkin's lymphoma (SIR ¼ 11.5), liver (SIR ¼ 3.6), oral cavity and pharynx (SIR ¼ 2.6), respiratory (SIR ¼ 2.6), leukemia (SIR ¼ 2.4), skin melanoma (SIR ¼ 2.4), and prostate (SIR ¼ 1.7) cancers. Risk of liver cancer was lower with HAART use (relative hazard (RH) ¼ 0.32). Risk of anal cancer increased after 1995 (RH ¼ 2.9). Respiratory cancer (RH ¼ 0.40) and Hodgkin's lymphoma (RH ¼ 0.17) showed increased cancer survival time with HAART use, while anal cancer survival may have been slightly decreased (RH ¼ 1.4). The impact of HAART on non-AIDSdefining cancer incidence rates and survival is not uniform, and the mechanism(s) responsible for these differences should be investigated further. acquired immunodeficiency syndrome; antiretroviral therapy, highly active; HIV infections; incidence; neoplasms; survival Abbreviations: AIDS, acquired immunodeficiency syndrome; HAART, highly active antiretroviral therapy; HIV, human immunodeficiency virus; RH, relative hazard; SEER, Surveillance, Epidemiology, and End Results; SIR, standardized incidence ratio.
Prevalence of Adenomas Found on Colonoscopy in Patients With HIV
Gastroenterology Research, 2012
Elmer This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
HIV infection and cancer in the era of highly active antiretroviral therapy (Review)
Oncology Reports, 2007
The majority of cancers affecting HIV-infected subjects are those established as acquired immunodeficiency syndrome (AIDS)-defining: Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL), and invasive cervical cancer (ICC). However, other types of cancer, such as Hodgkin's disease (HD), anal cancer, lung cancer and testicular germ cell tumors appear to be more common among HIV-infected subjects compared to the general population. While not classified as AIDS-defining, these malignancies have been referred to as AIDS-associated malignancies. The mechanisms by which depressed immunity could increase the risk for cancer are unclear, except for in KS and most subtypes of NHL, where it is strictly associated with a low CD4 count. Although it remains unclear whether HIV-1 acts directly as an oncogenic agent, it may contribute to the development of malignancies through several mechanisms (e.g., infection by oncogenic viruses, impaired immune surveillance, imbalance between cellular proliferation and differentiation). Studies of the effect of highly active antiretroviral therapy (HAART) on the incidence and progression of HIV/AIDS-associated cancers provided contrasting data. While a significant decrease in the incidence of KS has been observed, HAART has not had a significant impact on NHL incidence, particularly systemic NHL, or on ICC, HD, anal cancers and other non-AIDSdefining cancers. Regardless of whether these cancers are directly related to HIV-induced immunodeficiency, treating cancer in HIV-infected patients remains a challenge because of drug interactions, compounded side effects, and the potential effect of chemotherapy on CD4 count and HIV-1 viral load. A better knowledge of viral mechanisms of immune evasion and manipulation will provide the basis for a better management and treatment of the malignancies associated with chronic viral infections. Contents 1. Introduction 2. AIDS-defining cancers 3. Non-AIDS-defining cancers 4. Other malignancies in the HIV-infected community 5.
Malignancies in individuals living with HIV/AIDS
Romanian Journal of Infectious Diseases, 2024
Background. The incidence of malignancy is heightened in individuals infected with Human Immunodeficiency Virus (HIV). Despite a decrease in the incidence of HIV infections resulting from antiretroviral therapy (ART), the prevalence of HIV-associated malignancies remains substantial. Objective. Our objective was to examine the types of cancer that initially manifest in individuals infected with HIV or emerge during their subsequent observation period. Material and method. The study conducted a retrospective analysis of demographic characteristics, malignancy types, presenting symptoms, mode of transmission, HIV-RNA levels, and CD4/CD8 ratios in individuals living with HIV who developed malignancies and were under follow-up at the Infectious Diseases Polyclinic between October 2018 and December 2022. Results. Out of the 465 patients who were monitored during the study, 27 individuals (5.8%) were diagnosed with various malignancies. Among these patients, 22 (81%) were men and 5 (19%) were women. The average age of the patients ranged from 45.87±9.12 years. Among the patients, 17 (63%) were married and 10 (17%) were single. In terms of education, 16 patients (59.3%) had completed primary school, 7 patients (25.9%) were university graduates, and 4 patients (14.8%) had completed high school. The mode of HIV transmission in all patients was through sexual intercourse. The reasons for testing varied, with 8 patients (29.7%) being tested due to fever, 6 patients (22.2%) before undergoing surgery, 3 patients (11.1%) due to weight loss, and 2 patients (7.4%) tested for reasons such as job application, diarrhea, pre-blood donation, lymphadenomegaly, and dysphagia. The most common types of malignancies observed in the patients were non-Hodgkin's lymphoma (NHL) with 11 cases (40.7%), followed by Kaposi's sarcoma (KS) with 5 cases (18.5%), and cervical carcinoma with 3 cases (11.1%). Conclusion. The incidence of cancer is higher among individuals with HIV. There is a need to enhance the awareness among both healthcare providers who specialize in HIV care and those who do not.
Infection with human immunodeficiency virus type 2 (HIV-2) is predominantly seen in West Africa, but has increasing incidence in the United States and Europe. Differentiating an HIV-2 infection from the more well-known human immunodeficiency virus type 1 (HIV-1) infection may be challenging, but is an important distinction due to differences in the natural history and treatment of the two viral infections. Anal squamous cell carcinoma (ASCC) is known to be a Human Papilloma Virus (HPV) driven malignancy, but is not classified as an AIDS defining illness, despite an increased incidence of ASCC in HIV-seropositive individuals. The utilization of chemoradiotherapy and the appropriate anti-retroviral therapy (ART) is the recommended treatment for squamous cell anal carcinoma in HIV-seropositive individuals. We present a case of a 76-year-old female emigrant from Cape Verde, who presented with a history of anal pain and rectal bleeding. She was initially considered to be HIV-1 positive, but was then lost to follow up and seven years later she presented with stage IIIB ASCC. Interestingly, on her second presentation to medical care she was found to be HIV-2 positive and HIV-1 negative during screening labs conducted prior to commencing chemoradiotherapy. Here we discuss the challenges in treatment of ASCC in this patient and in diagnosis and treatment of HIV-2.
Malignancy in HIV/AIDs: A single hospital experience
Journal of Surgical Oncology, 2000
Background and Objectives: Our hospital serves an area with a significant number of patients seropositive for the human immunodeficiency virus (HIV). Intravenous drug abuse and heterosexual exposure are by far the predominant risk factors for HIV and acquired immunodeficiency syndrome (AIDS). Seven percent of these patients develop malignancies. Our aim was to study the types of tumor, their distribution, and to evaluate the patients' outcome. Methods: Of 3,578 patients with HIV infection or AIDS treated between 1993 and 1998, 245 had 1 or more malignancies. Information was collected on age, sex, race, predisposing risk factors for AIDS, malignancies, symptoms at presentation, the time of the onset of AIDS, CD4 cell counts, pathology findings, and mortality. Results: Although aspects of our patients resembled those of previously studied groups of patients with AIDS, there also were ways in which our patients differed from those other groups. Of our patients, 21.6% had non-AIDS-defining (NAD) invasive malignancies. This was considerably higher than the rate in most studies. Twenty-seven patients with such malignancies died during the study. Forty-two other patients had preinvasive cancers. Among patients having AIDS-defining (AD) malignancies, 55.9% died, a fact that was related to patients' low CD4 cell counts and late presentation. Our 97 patients with Kaposi sarcoma included 22 women, a relatively high number that may be related to the fact that most of our patients were intravenous drug abusers or had become infected by heterosexual transmission of HIV. Conclusions: AIDS is associated with a high risk of malignancy and an unusual spectrum of tumors. Patients with invasive tumors have advanced disease at the time of initial presentation. Those with AD tumors have a worse prognosis than patients with NAD tumors. The impact of highly active antiretroviral therapy on both AD and NAD tumors needs to be further evaluated.