[Malignancies in HIV infected patients: study of 139 cases].

BACKGROUND AND

OBJECTIVE

Since the introduction of highly active antiretroviral therapy (HAART), the natural history of HIV infection has been altered by an increasing survival. Following this, neoplastic diseases have become more common in HIV positive patients. The purpose of this study was to describe the types of tumor, clinical features and prognosis of HIV infected patients with malignant diseases. PATIENTES AND

METHODS

A descriptive study of epidemiological and clinical features was undertaken at Hospital Carlos III, in Madrid. Information was collected on age, sex, risk factors for HIV, HBV/HCV coinfection, malignancies, diagnosis of AIDS, viral load and CD4 cell counts at diagnosis, antiretroviral therapy and mortality. A total of 139 HIV-infected patients were identified who had at least one malignancy. Statistical analysis was performed using SPSS 15.0 package.

RESULTS

Types of malignancy were Kaposi's Sarcoma (n=43, 30.9%); non-Hodgkin lymphoma (n=42, 30.2%); gynecologic malignancy (n=16, 11.5%); Hodgkin's disease (n=15, 10.8%); hepatocellular carcinoma (n=7, 5%) and others (n=16, 11.5%). Mean age at diagnosis was 40 years (IC 95% 38.51-1.50). Male/female ratio was 3.63. Patients with HBV or HCV coinfection were 1.4% and 35.3% respectively. Risk factor for HIV was MSM (n=64;46%), IDUs (n=48; 34.5%) and heterosexual (n=26; 18.7%). Viral load was undetectable in 27 cases (19.4%); CD4 cell count was<200 cell/mcl in 58 cases (41.7%). There were 77 (55.4%) patients on HAART when cancer was diagnosed. Mean time on HAART was 23.31 months. Ten patients (7.2%) developed a secondary tumor. Twelve years survival was 20%.

CONCLUSIONS

Increased survival of HIV-infected patients receiving HAART makes it possible the development of secondary tumors and AIDS- unrelated malignancies, sometimes related to another virus.