New anti-retroviral therapies have changed the natural history of HIV. Oncological disease increases its role against infectious complications. Currently, they are one of the main reasons for death and hospitalization. AIDS-defining cancers (ADCs) are Kaposi's sarcoma, non-Hodgkin lymphoma (NHL) and cervical carcinoma. The other cancers are non-AIDS defining (NADCs).
An observational, retrospective study of a cohort of patients (p) with HIV-controlled in an Infectious Diseases unit and / or Medical Oncology for 11 years (2004 -2014) was conducted. ADCs and NADs are included, prognostic variables and epidemiological data were analyzed in relation to HIV and tumoral pathology.
Of 780 p HIV, 101 tumors were diagnosed in 91 p (12%). Males 71%. Mean age 46 years. In order of frequency: NHL 21 p (23%), lung carcinoma 13 p (14%), Kaposi's sarcoma 9 p (10%), hepatocellular carcinoma 7p (8%). Second malignancy was targeted in 10 p (11%). Since 2009 diagnosis of NADCs, it has increased 54 p (65%) opposite to ADCs 37 p (40%) (p 0.027). 30 p (33%) have achieved complete response of the oncological pathology, 9p (11%) progression and 52 p (56%) death. 42 p (46.2%) had viral load undetectable tumor diagnosis and 30p (33%) CD4 count> 500 / mm3. Of the 91 p, 48 p (53%) had HCV coinfection, 9p (10%) EBV or HPV and 50 p (54%) HBsAg positive. 57 p (63%) smokers> 20 cigarettes / day, 26 p (29%) habitual consumption alcohol. 40 p (44%) had diagnosed > 10 years with HIV and 20 p (22%) HIV diagnosis was made simultaneously to the tumor. SG from HIV diagnosis to exitus in ADCs was 2 years (CI 0- 6,597) and NADCs was 14 years (CI 12,7 - 15.3) (p 0.007 0.397 HR CI 0.204 to 0.773).
Our study confirms the appearence of malignancies earlier than in the general population and a significant increase in males not present in other studies. In relation to previous studies, we targeted the change of trend in the complications of p HIV. NADCs prevalence is progressively higher than the ADCs. In our series, it was observed a reduction risk of death 60,3 % for the patients with HIV infection and NADCs against the ADCs. It has also increased the prevalence of secondary tumors.
Clinical trial identification
Legal entity responsible for the study
Department of Medical Oncology
All authors have declared no conflicts of interest.