The Changing Face of HIV-Associated Malignancies: Is this the Same in Turkey As Well?

INTRODUCTION

Cancers remain a major cause of mortality among individuals with HIV infection. This study aimed to determine the incidence, prevalence, and mortality of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) in people living with HIV (PLWH).

METHODS

This retrospective, cross-sectional study was conducted in Istanbul. Among patients diagnosed with HIV/AIDS between January 2011 and December 2019, those who developed cancer were analyzed. To assess changes in cancer types over time, the study period was divided into three-year intervals.

RESULTS

Cancer was diagnosed in 57 (3.9%) of the 1,438 patients. The mean CD4 count was 272.3/mm³. Patients in the cancer group had significantly higher mean age at HIV diagnosis, higher HIV RNA levels, and lower CD4+ T lymphocyte counts. A notably high rate (72%) of simultaneous diagnosis of cancer and HIV was observed in the ADCs group. Kaposi sarcoma was identified in 23 (71.8%) patients, and non-Hodgkin lymphoma (NHL) in 9 patients. Hodgkin lymphoma and lung cancer were the most common cancers in the NADCs group.

DISCUSSION: People living with HIV are experiencing longer life expectancy due to ART; however, this also increases cancer risk, emphasizing the need for national screening guidelines that consider age, gender, and immune status. A multidisciplinary approach is essential for effective prevention and treatment strategies. Since cancer risk is multifactorial, larger prospective and multicenter studies are needed to strengthen and expand these findings.

CONCLUSIONS

These findings highlight that AIDS-defining cancers continue to be a significant clinical concern in Turkey. Cancer screening should be integrated both at the time of HIV diagnosis and during routine follow-up of PLWH.