摘要 :
Background : Since the advent of combination antiretroviral therapy (cART), non-AIDS defining malignancies (NADM) have become increasingly important. We examined risk factors for NADM, including immunological, virological and soci...
展开
Background : Since the advent of combination antiretroviral therapy (cART), non-AIDS defining malignancies (NADM) have become increasingly important. We examined risk factors for NADM, including immunological, virological and socio-behavioral characteristics. Methods: We linked the Swiss HIV Cohort Study (SHCS) with cancer registries to identify incident cancers between 1996 and 2012. We analyzed four common NADM: anal, lung, prostate, and liver cancer. We calculated standardized incidence ratios (SIRs) and assessed the effect of time-updated CD4 and CD8 count, CD4/CD8 ratio, and HIV viral load (copies/ml) in Cox regression models. We lagged time-dependent variables for 12, 24, and 36 months and captured cumulative exposures using simple moving averages (SMA). In multivariable models, we also considered HIV transmission group, smoking, and chronic hepatitis B or C infection as potential predictors of NADM incidence. Results. Between 1996 and 2012, 563 HIV-infected individuals developed NADM, including 70 anal, 49 lung, 44 prostate, and 36 liver cancers. Compared with the general population, the SHCS exhibited higher rates of anal (SIR 76.1, 95% Confidence interval (CI) 60.2-96.2), lung (SIR 1.98, 1.50-2.62), and liver cancer (SIR 7.28, 5.25-10.1) but similar rates of prostate cancer (SIR 1.03, 0.76-1.38). Anal cancer was associated with low CD4 cell count, high CD8 cell count, men who have sex with men, and smoking. For lung cancer, the CD8 cell count was the only significant predictor identified among the immunological and virological factors. CD4 cell count, and chronic hepatitis B and C infection were predictive of liver cancer incidence. We found no evidence of any of the immunological factors being associated with prostate cancer. Conclusions: The importance of immunodeficiency (indexed by CD4 count) and immune senescence (indexed by CD8 count) differs across NADM. Immunodeficiency was an important risk factor for anal and liver cancer whereas immune senescence was associated with lung cancer and anal cancer.
收起
摘要 :
Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered...
展开
Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection.
收起
摘要 :
Background & objectives: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India....
展开
Background & objectives: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India.
收起
摘要 :
Background & objectives: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India....
展开
Background & objectives: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India.
收起
摘要 :
The incidence of AIDS-defining cancers (ADCs) - Kaposi sarcoma, primary central nervous system lymphoma, non-Hodgkin lymphoma, and cervical cancer - although on the decline since shortly after the introduction of HAART, has contin...
展开
The incidence of AIDS-defining cancers (ADCs) - Kaposi sarcoma, primary central nervous system lymphoma, non-Hodgkin lymphoma, and cervical cancer - although on the decline since shortly after the introduction of HAART, has continued to be greater even in treated HIV-infected persons than in the general population. Although the survival of newly infected people living with HIV/AIDS now rivals that of the general population, morbidity and mortality associated with non-AIDS-defining cancers (NADCs) such as lung, liver, anal, and melanoma are significant and also continue to rise. Increasing age (i.e. longevity) is the greatest risk factor for NADCs, but longevity alone is not sufficient to fully explain these trends in cancer epidemiology. In this review, we briefly review the epidemiology and etiology of cancers seen in HIV/AIDS, and in this context, discuss preclinical research and broad treatment considerations. Investigation of these considerations provides insight into why malignancies continue to be a major problem in the current era of HIV/AIDS care.
收起
摘要 :
People living with HIV are at an increased risk of cancer and often face worse outcomes because of treatment disparities, including increased mortality. When the immune system is severely compromised from HIV infection, AIDS can d...
展开
People living with HIV are at an increased risk of cancer and often face worse outcomes because of treatment disparities, including increased mortality. When the immune system is severely compromised from HIV infection, AIDS can develop and result in an even greater risk for life-threatening disease or cancer. In addition, patients with HIV receiving cancer treatment require close monitoring for potential drug interactions and toxicities, particularly related to preventing opportunistic infections. Oncology nurses are ideal patient advocates to promote cancer prevention and screening strategies among this population. This article reviews associated risk factors for AIDS-defining and non-AIDS-defining cancers in patients with HIV.
收起
摘要 :
Achievement and maintenance of virologic suppression after cancer diagnosis have been associated with improved outcomes in HIV-infected patients, but few studies have analyzed the virologic and immunologic outcomes after a cancer ...
展开
Achievement and maintenance of virologic suppression after cancer diagnosis have been associated with improved outcomes in HIV-infected patients, but few studies have analyzed the virologic and immunologic outcomes after a cancer diagnosis. All HIV-infected patients with a diagnosis of cancer between 2000 and 2011 in an urban clinic population in Baltimore, MD, were included for review. HIV-related outcomes (HIV-1 RNA viral load and CD4 cell count) were abstracted and compared for patients with non-AIDS-defining cancers (NADCs) and AIDS-defining cancers (ADCs). Four hundred twelve patients with baseline CD4 or HIV-1 RNA viral load data were analyzed. There were 122 (30%) diagnoses of ADCs and 290 (70%) NADCs. Patients with NADCs had a higher median age (54 years vs. 43 years, p < .0001) and a higher frequency of hepatitis C coinfection (52% vs. 36%, p = .002). The median baseline CD4 was lower for patients with ADCs (137 cells/mm 3 vs. 314 cells/mm 3) and patients with NADCs were more likely to be suppressed at cancer diagnosis (59% vs. 25%) (both p < .0001). The median CD4 for patients with NADCs was significantly higher than patients with ADCs at 6 and 12 months after diagnosis and higher at 18 and 24 months, but not significantly. Patients with an NADC had 2.19 times (95% CI 1.04-4.62) the adjusted odds of being suppressed at 12 months and 2.17 times the odds (95% CI 0.92-5.16) at 24 months compared to patients with an ADC diagnosis. For patients diagnosed with ADCs and NADCs in this urban clinic setting, both virologic suppression and immunologic recovery improved over time. Patients with NADCs had the highest odds of virologic suppression in the 2 years following cancer diagnosis.
收起
摘要 :
Non-AIDS defining cancers (NADCs) have been an increasing cause of morbidity and mortality in patients with HIV. There is no data on the spectrum of NADCs in Mexico. We describe the type of neoplasms, clinical characteristics, and...
展开
Non-AIDS defining cancers (NADCs) have been an increasing cause of morbidity and mortality in patients with HIV. There is no data on the spectrum of NADCs in Mexico. We describe the type of neoplasms, clinical characteristics, and outcomes of HIV-infected patients with NADCs. We conducted a retrospective study of all patients with confirmed diagnosis of NADC attending the HIV/AIDS clinic at the National Cancer Institute in Mexico City (a tertiary-care center for adult patients with cancer) from January 1990 to December 2016. From 1126 HIV-positive individuals seen at the institute since 1990, 127 (11.3%) were diagnosed with NADCs; seven patients developed two NADCs during their follow-up. At diagnosis of NADC median age was 43.7?±?10.9?years; 101 (79.5%) were male; median CD4 was 273 cells/mm3, 70 patients had a CD4 count of?>?200 cells/mm3, 73 had undetectable HIV viral load and 82 had taken combined antiretroviral therapy (cART) for more than 1?year. The most frequent NADCs were in men, Hodgkin lymphoma (34.3%) followed by anal cancer (15.7%), whereas in women, were vulvo-vaginal cancers associated to human papilloma virus (HPV) (51.8%), followed by breast cancer (25.9%). The main risk factor associated with death was cancer progression or relapse (OR, 28.2, 2.5–317.1; p?=?0.007). HL- and HPV-related neoplasms are the commonest NADC in a cancer referral hospital from a middle-income country with universal access to cART since year 2005. Screening for early anogenital lesions should be emphasized in patients with HIV. It is essential to establish multidisciplinary groups involving Hemato-oncologists, Oncologists, Gynecologists, and HIV Specialists in the treatment of these patients.
收起
摘要 :
ObjectivesWe used population-based data to identify incident cancer cases and correlates of cancer among women living with HIV/AIDS in British Columbia (BC), Canada between 1994 and 2008.
原文获取