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Zhang Y, Xu P, Yu X, Zhuang K, Gui X, Yang R. Plasma proteomic analysis reveals altered protein abundances in HIV/HBV co-infection individuals with HCC and with liver cirrhosis. Sci Rep 2025; 15:15871. [PMID: 40335608 PMCID: PMC12059059 DOI: 10.1038/s41598-025-99072-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 04/16/2025] [Indexed: 05/09/2025] Open
Abstract
To develop a risk prediction model for hepatocellular carcinoma (HCC) by screening differentially expressed proteins (DEPs) in HIV/HBV coinfected patients with HCC and liver cirrhosis using proteomic techniques. DEPs were identified in plasma from HIV/HBV co-infected patients with HCC and liver cirrhosis using quantitative liquid chromatography-mass spectrometry (LC-MS). Mapping discovered proteins to the Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Disease Ontology (DO) databases yielded annotation information for DEPs. Differential plasma apolipoprotein A-1(APOA1) and transthyretin (TTR) expression levels were validated in 88 HIV/HBV co-infected individuals with HCC and liver cirrhosis. In total, 150 DEPs were discovered. The GO entries were primarily enriched for cutaneous immunological response mediated by circulating immunoglobulin and complement activation, as well as lipoprotein particle. The KEGG pathway enrichment was dominated by complement and coagulation cascades. Six of the 15 items enriched in the DO entries were related to lipid metabolism. APOA1, TTR, Prothrombin (F2), Antithrombin-III (SERPINC1), Alpha-2-HS-glycoprotein (AHSG), Alpha-2-macroglobulin (A2M) and Haptoglobin-related protein (HPR) were finally identified as hub proteins. Finally, a visual logistic model using immunoglobulin heavy variable 3-13 (IGHV3-13) and A2M to predict HCC were constructed. Significant variations in plasma APOA1 and TTR levels were found in HIV/HBV co-infected patients with HCC and liver cirrhosis. The screened hub proteins from DEPs can be employed as possible markers for early HCC detection. The developed HCC prediction model can be used to assess the risk of HCC in HIV/HBV co-infected cirrhotic individuals.
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Affiliation(s)
- Yongxi Zhang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China
| | - Ping Xu
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xingxia Yu
- Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ke Zhuang
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
| | - Xien Gui
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China
| | - Rongrong Yang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
- Center for AIDS Research, Wuhan University, Wuhan, Hubei, China.
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Ma Y, Zhang J, Xiao J, Yang X, Weissman S, Li X, Olatosi B. Association Between Dynamic Viral Rebound and Longitudinal Measures of Viral Load/CD4 Counts Among People with HIV in South Carolina. AIDS Res Hum Retroviruses 2025; 41:253-262. [PMID: 39686710 DOI: 10.1089/aid.2024.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2024] Open
Abstract
Monitoring HIV viral rebound (VR) is crucial, as it indicates an increased risk of infection, transmission, disease progression, and drug resistance. This study aims to identify the association between dynamic VR and historical viral load (VL)/CD4 count measures. Fifteen-year South Carolina population-based electronic health record data were used for the study. VR was defined as the return of detectable levels of VL (>200 copies/mL) after stable viral suppression (VS) (two consecutive VS, i.e., VL ≤200 copies/mL). A generalized linear mixed model was used to evaluate the association between dynamic VR and historical time-dependent predictors, such as nadir CD4 count and comorbidities, within a year prior to each VR. Subgroup analysis for men who have sex with men (MSM) was also conducted. Among 8,185 people with HIV (PWH), 1,173 (14.3%) had a history of VR. Lower nadir CD4 count (≥500 vs. <200 cells/µL; adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: [0.43, 0.60]), younger age (>60 years old vs. 18-30 years old; aOR: 0.43, 95% CI: [0.29, 0.63]), and being Black (Black vs. White; aOR: 1.58, 95% CI: [1.34, 1.85]) were associated with a higher risk of VR, while MSM (MSM vs. heterosexual; aOR: 0.81, 95% CI: [0.67, 0.96]) were associated with decreased VR risk. The rate of VR among PWH in South Carolina is significant. Within-1-year VL/CD4 test is critical for identifying PWH at risk for VR. Tailored interventions are needed for PWH at risk for VR to achieve sustained suppression and better health outcomes.
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Affiliation(s)
- Yunqing Ma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina SmatState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jiayang Xiao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xueying Yang
- South Carolina SmatState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sharon Weissman
- South Carolina SmatState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Internal Medicine, School of Medicine, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaoming Li
- South Carolina SmatState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Bankole Olatosi
- South Carolina SmatState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Liang Y, Chang J, Gao Y, Zhang L, Chen X, Zheng C, Sun Y, Zhang X, Guo C, Zhang Y. Development of a novel prognostic nomogram for AIDS-associated diffuse large B-cell lymphoma: a retrospective study from northern China. Clin Exp Med 2025; 25:62. [PMID: 39964648 PMCID: PMC11835908 DOI: 10.1007/s10238-025-01586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 02/03/2025] [Indexed: 02/21/2025]
Abstract
Despite advancements in antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a major cause of morbidity and mortality. Compared to non-HIV-infected individuals, AR-DLBCL presents with considerable disease heterogeneity, which impairs the accuracy of current prognostic tools. This study aims to develop a novel prognostic model to enhance risk assessment for AR-DLBCL. We retrospectively analyzed 90 AR-DLBCL cases using univariate and multivariate analyses to identify clinical factors affecting overall survival (OS) and progression-free survival (PFS). A nomogram was created based on independent OS risk factors. The cohort had a median age of 43 years (range: 22-75), with 96.5% male patients. The median follow-up was 30 months (range: 1-139), with 5-year OS and PFS rates of 60.7% and 58.7%, respectively. Key prognostic factors for OS included decreased absolute lymphocyte count (p = 0.002), extranodal involvement (p = 0.005), reduced hemoglobin (Hb) levels (p = 0.004), Epstein-Barr virus (EBV) infection (p = 0.005), and elevated lactate dehydrogenase (LDH) levels (p = 0.018). The nomogram demonstrated robust predictive performance, with a 5-year receiver operating characteristic curve area under the curve of 0.949. Its C-index of 0.849 surpassed the International Prognostic Index (IPI) and age-adjusted IPI (aaIPI), which had C-index of 0.708 and 0.693, respectively. Additionally, the nomogram identified significant OS differences among low risk, intermediate-low risk, intermediate-high risk, and high-risk groups, with 5-year survival rates of 100%, 88%, 56%, and 8%, respectively. The model offers a personalized risk assessment for AR-DLBCL patients, facilitating precise prognosis prediction and informing individualized treatment strategies.
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Affiliation(s)
- Ying Liang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Jing Chang
- Department of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yuxue Gao
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Ling Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xue Chen
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Caopei Zheng
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yuqing Sun
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xiuqun Zhang
- Department of Hematology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Caiping Guo
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
| | - Yulin Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China.
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Cho H, Kalina E, Wu J, Cook R, Salloum R, Liu Y, Bian J, Guo J, Starkweather A. A Scoping Review of Observational Research on Cannabis Use for Symptom Management in HIV and Cancer: Implications for Cannabis Nursing. J Clin Nurs 2025; 34:422-429. [PMID: 39603980 PMCID: PMC11747838 DOI: 10.1111/jocn.17565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 10/26/2024] [Accepted: 11/04/2024] [Indexed: 11/29/2024]
Abstract
BACKGROUND People with HIV have a higher risk of developing non-AIDS-defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations. AIM To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full-text review and 51 were retained for data extraction. RESULTS There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross-sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet. IMPLICATIONS FOR CANNABIS NURSING This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Hwayoung Cho
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, United States
| | - Elena Kalina
- Department of Health Education Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Jianli Wu
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, Florida, United States
| | - Robert Cook
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Ramzi Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Yiyang Liu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, United States
| | - Angela Starkweather
- Division of Nursing Science, School of Nursing, Rutgers University, Newark, New Jersey, United States
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Vaghela G, Khan ZA, Elsheikh R, Makram AM, Fatima A, Makram OM, He F, Huy NT. Planetary Health Booms: Unpacking the Surge in Research Across the Globe Through Joint-Point Analysis. GEOHEALTH 2024; 8:e2024GH001028. [PMID: 39539695 PMCID: PMC11558129 DOI: 10.1029/2024gh001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 11/16/2024]
Abstract
Planetary Health (PH) is a relatively new field that studies the sciences behind the interaction between the environment, living organisms, and human health. The number of publications in this field has increased exponentially in the past few years. This study analyzed the trend of using the term "PH" in literature. We searched PubMed for all publications (APP) and those mentioning Planetary Health (APmPH) without limitations on text availability, dates, or species. The publication trend was estimated using the average annual percent change (AAPC). Joinpoint Regression Program 4.9.1.0 identified periods with statistically distinct log-linear trends in publication numbers over time. Bonferroni adjustment determined significant trend shifts. The time frame of the retrieved APP and APmPH results ranged from 2002 to 2022 with a publication boom since 2017. The most common study designs were reviews, followed by comments and editorials. The APP, APmPH, and the proportion of APmPH to APP steadily increased from 2002 to 2022, with an AAPC of 6.0% (95% CI: 4.4%-7.6%, p < 0.001), 35.7 (95% CI: 21.3%-51.9%, p < 0.001), and 28.1% (95% CI: 15.2-42.5, p < 0.001), respectively. The term "PH" is increasingly prominent in academic literature, underscoring the need for interdisciplinary efforts. Its growing usage also highlights the need for recognition in Medical Subject Headings by the National Library of Medicine.
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Affiliation(s)
- Gladson Vaghela
- Gujarat Medical Education and Research Society Medical CollegeGandhinagarIndia
- Online Research ClubNagasakiJapan
| | - Zeeshan Ali Khan
- Online Research ClubNagasakiJapan
- Shadan Institute of Medical SciencesHyderabadIndia
| | - Randa Elsheikh
- Online Research ClubNagasakiJapan
- Deanery of Biomedical Sciences at Edinburgh Medical SchoolUniversity of EdinburghEdinburghUK
| | - Abdelrahman M. Makram
- Online Research ClubNagasakiJapan
- School of Public HealthImperial College LondonLondonUK
| | - Arshia Fatima
- Online Research ClubNagasakiJapan
- Department of MedicineDeccan College of Medical SciencesTelanganaIndia
| | - Omar Mohamed Makram
- Online Research ClubNagasakiJapan
- Department of CardiologyFaculty of MedicineOctober 6 UniversityGizaEgypt
- Center for Health & NatureHouston Methodist Research InstituteHoustonTXUSA
| | - Fei He
- Department of Epidemiology and Health StatisticsSchool of Public HealthFujian Medical UniversityFuzhouChina
- Fujian Provincial Key Laboratory of Tumor MicrobiologyFujian Medical UniversityFuzhouChina
| | - Nguyen Tien Huy
- Online Research ClubNagasakiJapan
- Institute of Research and DevelopmentDuy Tan UniversityDa NangVietnam
- School of Medicine and PharmacyDuy Tan UniversityDa NangVietnam
- School of Tropical Medicine and Global HealthNagasaki UniversityNagasakiJapan
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6
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Gao Z, Xu G, Wang S, Guo N, Yu Y, Wang X. Unusual presentation of PD-1 inhibitors in people living with HIV with advanced gastric cancer: Case report. Int J STD AIDS 2024; 35:733-738. [PMID: 38644514 DOI: 10.1177/09564624241248676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
This paper seeks to determine the effect of combination anti-PD-1 and antiretroviral therapy (ART) on people living with HIV (PLWH) with advanced gastric cancer. In our case, a PLWH with recurrent locally advanced gastric cancer was treated with anti-PD-1 inhibitor and ART. A significant reduction in tumor lesions (as demonstrated by contrast-enhanced CT imaging) and a better quality of life were achieved following treatment. There have been limited studies on the treatment of PLWH with advanced gastric cancer. Chemotherapy is most often used, however, with unsatisfactory outcomes. to date, there have been no published reports on the use of PD-1 inhibitors in PLWH with advanced gastric cancer. Our report provides a valuable reference for future management of such patients.
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Affiliation(s)
- Zhidi Gao
- Department of Oncology, Qingdao Branch of Shandong Public Health Clinical Center, Qingdao, People's Republic of China
| | - Guangyong Xu
- Department of Infectious Diseases, Qingdao Branch of Shandong Public Health Clinical Center, Qingdao, People's Republic of China
| | - Su Wang
- Department of Oncology, Hiser Hospital Affiliated to Qingdao University, Shandong, People's Republic of China
| | - Na Guo
- Department of Oncology, Qingdao Branch of Shandong Public Health Clinical Center, Qingdao, People's Republic of China
| | - Yang Yu
- Department of Oncology, Qingdao Branch of Shandong Public Health Clinical Center, Qingdao, People's Republic of China
| | - Xiaoni Wang
- Imaging Department, Qingdao Branch of Shandong Public Health Clinical Center, Qingdao, People's Republic of China
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Linfield RY, Nguyen NN, Laprade OH, Holodniy M, Chary A. An update on drug-drug interactions in older adults living with human immunodeficiency virus (HIV). Expert Rev Clin Pharmacol 2024; 17:589-614. [PMID: 38753455 PMCID: PMC11233252 DOI: 10.1080/17512433.2024.2350968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION People with HIV are living longer due to advances in antiretroviral therapy. With improved life expectancy comes an increased lifetime risk of comorbid conditions - such as cardiovascular disease and cancer - and polypharmacy. Older adults, particularly those living with HIV, are more vulnerable to drug interactions and adverse effects, resulting in negative health outcomes. AREA COVERED Antiretrovirals are involved in many potential drug interactions with medications used to treat common comorbidities and geriatric conditions in an aging population of people with HIV. We review the mechanisms and management of significant drug-drug interactions involving antiretroviral medications and non-antiretroviral medications commonly used among older people living with HIV. The management of these interactions may require dose adjustments, medication switches to alternatives, enhanced monitoring, and considerations of patient- and disease-specific factors. EXPERT OPINION Clinicians managing comorbid conditions among older people with HIV must be particularly vigilant to side effect profiles, drug-drug interactions, pill burden, and cost when optimizing treatment. To support healthier aging among people living with HIV, there is a growing need for antiretroviral stewardship, multidisciplinary care models, and advances that promote insight into the correlations between an individual, their conditions, and their medications.
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Affiliation(s)
| | - Nancy N. Nguyen
- Department of Pharmacy, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA, USA
| | - Olivia H. Laprade
- Department of Pharmacy, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA, USA
| | - Mark Holodniy
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- National Public Health Program Office, Veterans Health Administration, Palo Alto, CA, USA
| | - Aarthi Chary
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- National Public Health Program Office, Veterans Health Administration, Palo Alto, CA, USA
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Tanaka T, Oshima K, Kawano K, Tashiro M, Kakiuchi S, Tanaka A, Fujita A, Ashizawa N, Tsukamoto M, Yasuoka A, Teruya K, Izumikawa K. Nationwide Longitudinal Annual Survey of HIV/AIDS Referral Hospitals in Japan From 1999 to 2021: Trend in Non-AIDS-defining Cancers Among Individuals Infected With HIV-1. J Acquir Immune Defic Syndr 2024; 96:1-10. [PMID: 38427920 PMCID: PMC11008444 DOI: 10.1097/qai.0000000000003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Non-AIDS-defining cancers (NADCs) in patients infected with HIV have recently attracted attention because of the improved survival of this patient population. To obtain accurate data, a longitudinal study is warranted for the nationwide surveillance of the current status and national trend of NADCs in patients infected with HIV in Japan. SETTING An annual nationwide surveillance of NADCs in patients infected with HIV-1 in Japan from 1999 to 2021. METHODS An annual questionnaire was sent to 378 HIV/AIDS referral hospitals across Japan to collect data (clusters of differentiation 4-positive lymphocytes, time of onset, outcomes, and antiretroviral therapy status) of patients diagnosed with any of the NADCs between 1999 and 2021. RESULTS The response and case-capture rates for the questionnaires in 2021 were 37.8% and 81.2%, respectively. The number of reported NADC cases subsequently increased since the beginning of this study. Evaluation of the case counts of NADCs demonstrated a high incidence of lung, colorectal, gastric, and liver cancers as the top 4 cancers. Pancreatic cancer (0.63), lung cancer (0.49), and leukemia (0.49) had the highest mortality rates among the NADCs. Trends of NADCs regarding transmission routes were maintained over the years in male individuals who have sex with male individuals compared with heterosexual male individuals and female individuals. CONCLUSIONS We demonstrated an increasing trend in the incidence of NADCs over a period of 23 years in Japan. The current data highlighted the importance of raising awareness regarding cancer management for patients infected with HIV in Japan.
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Affiliation(s)
- Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Kazuhiro Oshima
- Department of Internal Medicine, Nagasaki Goto Chuoh Hospital, Goto-shi, Nagasaki, Japan
| | - Kei Kawano
- Department of Hospital Medicine, Urasoe General Hospital, Urasoe-shi, Okinawa, Japan
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Science, Nagasaki-shi, Nagasaki, Japan
| | - Satoshi Kakiuchi
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Akitaka Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
| | - Misuzu Tsukamoto
- Department of Internal Medicine, Zenjinkai Hospital, Miyazaki-shi, Miyazaki, Japan
| | - Akira Yasuoka
- Division of Internal Medicine, Michinoo Hospital, Nagasaki-shi, Nagasaki, Japan; and
| | - Katsuji Teruya
- Department of AIDS Clinical Center, Center Hospital of the National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki-shi, Nagasaki, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Science, Nagasaki-shi, Nagasaki, Japan
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Liu R, Zhao H, Xiao G, Tao Y, Tang X, Feng L, Liao B, Liu B, Guan J, Li L, Chen Z, He H, You H. Clinical Characteristics and Outcomes of AIDS-Related Burkitt Lymphoma in China: A Retrospective Single-Center Study. Technol Cancer Res Treat 2024; 23:15330338231214236. [PMID: 38179657 PMCID: PMC10771070 DOI: 10.1177/15330338231214236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives: Studies on the prognosis and risk stratification of patients with acquired immune deficiency syndrome (AIDS) - related Burkitt lymphoma (AR-BL) are rare. We aim to construct a novel model to improve the risk assessment of these patients. Methods: We retrospectively analyzed the clinical data of 34 patients over the past 10 years and the factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Then, the novel model consisting of screened factors was compared with the existing models. Results: With a 37-month median follow-up, the overall 2-year PFS and OS rates were 40.50% and 36.18%, respectively. The OS of patients who received chemotherapy was better compared with those without chemotherapy (P = .0012). Treatment with an etoposide, prednisone, oncovin, cyclophosphamide, and hydroxydaunorubicin-based regimen was associated with longer OS and PFS compared with a cyclophosphamide, doxorubicin, vincristine, and prednisone-based regimen (OS, P = .0002; PFS, P = .0158). Chemotherapy (hazard ratio [HR] = 0.075; 95% confidence interval [CI], 0.009-0.614) and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 2 to 4 (HR = 4.738; 95% CI, 1.178-19.061) were independent prognostic factors of OS in multivariate analysis and we established a novel prognostic risk stratification model named GZ8H model with chemotherapy and ECOG PS. Conclusion: GZ8H showed better stratification ability than the international prognostic index (IPI) or Burkitt lymphoma IPI (BL-IPI). Furthermore, the C-index of the nomogram used to predict OS was 0.884 in the entire cohort and the calibration curve showed excellent agreement between the predicted and actual results of OS. No human immunodeficiency virus-related factors were found to be associated with OS and PFS of AR-BL patients in our study. Overall, the clinical characteristics and outcomes in AR-BL were shown and prognostic factors for OS and PFS were identified in this study.
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Affiliation(s)
- Rongqiu Liu
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Han Zhao
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Guanying Xiao
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yu Tao
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoping Tang
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Lizhi Feng
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Baolin Liao
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Bo Liu
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jialong Guan
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhimin Chen
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Haolan He
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hua You
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Children's Hospital of Chongqing Medical University, Chongqing, China
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10
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Ma Y, Zhang J, Yang X, Chen S, Weissman S, Olatosi B, Alberg A, Li X. Association of CD4 + cell count and HIV viral load with risk of non-AIDS-defining cancers. AIDS 2023; 37:1949-1957. [PMID: 37382882 PMCID: PMC10538428 DOI: 10.1097/qad.0000000000003637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES HIV-induced immunodeficiency contributes to an increased risk of non-AIDS-defining cancers (NADC). This study aims to identify the most predictive viral load (VL) or CD4 + measures of NADC risk among people with HIV (PWH). DESIGN Extracted from South Carolina electronic HIV reporting system, we studied adult PWH who were cancer-free at baseline and had at least 6 months of follow-up since HIV diagnosis between January 2005 and December 2020. METHODS Using multiple proportional hazards models, risk of NADC was investigated in relation to 12 measures of VL and CD4 + cell count at three different time intervals before NADC diagnosis. The best VL/CD4 + predictor(s) and final model were determined using Akaike's information criterion. RESULTS Among 10 413 eligible PWH, 449 (4.31%) developed at least one type of NADC. After adjusting for potential confounders, the best predictors of NADC were the proportion of days with viral suppression (hazard ratio [HR]: 0.47 (>25% and ≤50% vs. 0), 95% confidence interval [CI]: [0.28, 0.79]) and proportion of days with low CD4 + cell count (AIC = 7201.35) (HR: 12.28 (>75% vs. = 0), 95% CI: [9.29, 16.23]). CONCLUSIONS VL and CD4 + measures are strongly associated with risk of NADC. In analyses examining three time windows, proportion of days with low CD4 + cell count was the best CD4 + predictor for each time window. However, the best VL predictor varied across time windows. Thus, using the best combination of VL and CD4 + measures for a specific time window should be considered when predicting NADC risk.
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Affiliation(s)
- Yunqing Ma
- Department of Epidemiology and Biostatistics
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics
- South Carolina SmatState Center for Healthcare Quality
| | - Xueying Yang
- South Carolina SmatState Center for Healthcare Quality
- Department of Health Promotion, Education and Behavior
| | - Shujie Chen
- Department of Epidemiology and Biostatistics
| | - Sharon Weissman
- South Carolina SmatState Center for Healthcare Quality
- Department of Internal Medicine, School of Medicine
| | - Bankole Olatosi
- South Carolina SmatState Center for Healthcare Quality
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | | | - Xiaoming Li
- South Carolina SmatState Center for Healthcare Quality
- Department of Health Promotion, Education and Behavior
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11
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Lui GCY, Hui VWK, Sze SF, Wong BCK, Cheung C, Lee MP, Yip TCF, Tse YK, Lai JCT, Chan HLY, Wong VWS, Hui YT, Wong GLH. Incidence of hepatocellular carcinoma and mortality in chronic viral hepatitis in an Asian population with and without HIV infection. Aliment Pharmacol Ther 2023; 58:814-823. [PMID: 37515399 DOI: 10.1111/apt.17654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/25/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND It is uncertain whether people with HIV infection have a higher incidence of hepatocellular carcinoma (HCC) than the general population. AIMS To compare the incidence of HCC between people infected with HBV and/or HCV with and without HIV METHODS: We performed a retrospective population-based cohort study, involving people with HBV and/or HCV infection from 2001 to 2018. The primary endpoint was incidence of HCC; secondary endpoint was all-cause mortality. We performed Cox proportional hazard regression models to estimate the hazard ratios (HR) of HIV for the primary and secondary endpoints. RESULTS We identified 1374 people infected with HIV and 39,908 people without HIV with HBV and/or HCV infection. Among those with HIV, 654 (47.6%) had HBV, 649 (47.2%) HCV and 71 (5.2%) HBV-HCV-co-infection; they were younger, and had a higher prevalence of HCV and a lower prevalence of cirrhosis. The incidence rate estimates of HCC were, respectively, 1.5 (95% CI: 0.8-2.5) and 7.6 (95% CI 7.3-8.0) per 1000 person-years for those with and without HIV infection. Using multivariate Cox proportional hazard regression models, among people with HBV, HIV was associated with lower risk of HCC (adjusted HR: 0.376, 95% CI: 0.201-0.704, p = 0.01) and death (adjusted HR: 0.692, 95% CI: 0.552-0.867, p = 0.007). Risks of HCC were similar for HCV and HBV-HCV co-infection for people with and without HIV. CONCLUSIONS Among individuals with HBV infection, the Incidence of HCC was lower in those with HIV. For HCV infection, incidence of HCC was similar between those with and without HIV.
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Affiliation(s)
- Grace Chung-Yan Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Vicki Wing-Ki Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Shun-Fung Sze
- Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, China
| | - Bonnie Chun-Kwan Wong
- Integrated Treatment Centre, Department of Health, Hong Kong, Special Administrative Region, China
| | - Catherine Cheung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Man-Po Lee
- Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, China
| | - Terry Cheuk-Fung Yip
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Yee-Kit Tse
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Jimmy Che-To Lai
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Henry Lik-Yuen Chan
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Union Hospital, Hong Kong, Special Administrative Region, China
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Yee-Tak Hui
- Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, China
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China
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12
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Akanbi MO, Bilaver LA, Achenbach C, Hirschhorn LR, Rivera AS, Adekolujo OS, Adekola KUA, Silas OA, Agaba PA, Agbaji O, Shehu NY, Sagay SA, Hou L, Murphy RL. Incident Kaposi sarcoma during the expansion of antiretroviral therapy eligibility in Nigeria: a retrospective cohort study. BMC Cancer 2023; 23:890. [PMID: 37735371 PMCID: PMC10512500 DOI: 10.1186/s12885-023-11402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION The expansion of antiretroviral therapy (ART) eligibility could lead to earlier initiation of Human Immunodeficiency Virus (HIV) treatment and consequently reduce the risk of HIV-associated Kaposi Sarcoma (KS). We investigated the impact of changes in the Nigerian HIV treatment guidelines on KS incidence among adults enrolled in HIV care in Nigeria. METHODS We analyzed data of adults who enrolled for HIV care from January 2006 to December 2016 at one of Nigeria's largest HIV treatment centers. Based on changes in HIV treatment guidelines, we classified 2006-2009 as the pre-expansion period and 2010-2016 as the post-expansion period. We used Kaplan Meier curves to compare the incidence of KS in the pre-expansion to the post-expansion period. We used Cox regression models to assess the hazard for incident KS between the two periods after adjusting for potential confounders. RESULTS Among 14,479 patients with HIV, the overall KS incidence was 2.35; 95% CI 2.01-2.74/1,000 person-years. The incidence of KS decreased from 2.53 to 1.58 per 1,000 person-years from 2006 to 2009 to 2010-2016. In models adjusting for age, sex, CD4-T cell count, and ART use, the risk for KS remained lower in 2010-2016 compared to 2006-2009. In analyses restricted to time on ART, there was no significant difference in KS incidence between HIV patients who enrolled in 2006-2009 and 2010-2016 after adjusting for age, sex, and CD4 T-cell count. CONCLUSION The expansion of ART eligibility was associated with a reduced incidence of HIV-associated KS among adults initiating HIV care in Jos, Nigeria. The reduction was likely driven by earlier enrollment for HIV care and ART initiation.
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Affiliation(s)
- Maxwell O Akanbi
- Department of Hematology & Clinical Oncology, Michigan State University/ McLaren Greater Lansing, 2900 Collins Road, Michigan, 48910, USA.
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Department of Medicine, McLaren Hospital, Flint, MI, USA.
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria.
| | - Lucy A Bilaver
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chad Achenbach
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lisa R Hirschhorn
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Adovich S Rivera
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | | | | | - Patricia A Agaba
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Oche Agbaji
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Nathan Y Shehu
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Solomon A Sagay
- College of Medicine, University of Jos, Jos, Plateau State, Nigeria
| | - Lifang Hou
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert L Murphy
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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13
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Nicolau IA, Moineddin R, Antoniou T, Brooks JD, Gillis JL, Kendall CE, Cooper C, Cotterchio M, Salters K, Smieja M, Kroch AE, Lindsay JD, Price C, Mohamed A, Burchell AN. Trends in infection-related and infection-unrelated cancer incidence among people with and without HIV infection in Ontario, Canada, 1996-2020: a population-based matched cohort study using health administrative data. CMAJ Open 2023; 11:E894-E905. [PMID: 37816545 PMCID: PMC10569814 DOI: 10.9778/cmajo.20220230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND People with HIV infection are at higher risk for certain cancers than the general population. We compared trends in infection-related and infection-unrelated cancers among people with and without HIV infection. METHODS We conducted a retrospective population-based matched cohort study of adults with and without HIV infection using linked health administrative databases in Ontario, Canada. Participants were matched on birth year, sex, census division (rurality), neighbourhood income quintile and region of birth. We followed participants from cohort entry until the earliest of date of cancer diagnosis, date of death, Nov. 1, 2020, or date of loss to follow-up. Incident cancers identified from Jan. 1, 1996, to Nov. 1, 2020, were categorized as infection-related or-unrelated. We examined calendar periods 1996-2003, 2004-2011 and 2012-2020, corresponding to the early combination antiretroviral therapy (cART), established cART and contemporary cART eras, respectively. We used competing risk analyses to examine trends in cumulative incidence by calendar period, age and sex, and cause-specific hazard ratios (HRs). RESULTS We matched 20 304 people with HIV infection to 20 304 people without HIV infection. A total of 2437 cancers were diagnosed, 1534 (62.9%) among infected people and 903 (37.0%) among uninfected people. The risk of infection-related cancer by age 65 years for people with HIV infection decreased from 19.0% (95% confidence interval [CI] 15.6%-22.3%) in 1996-2011 to 10.0% (95% CI 7.9%-12.1%) in 2012-2020. Compared to uninfected people, those with HIV infection had similar HRs of infection-unrelated cancer but increased rates of infection-related cancer, particularly among younger age groups (25.1 [95% CI 13.2-47.4] v. 1.9 [95% CI 1.0-3.7] for age 18-39 yr v. ≥ 70 yr); these trends were consistent when examined by sex.Interpretation: We observed significantly higher rates of infection-related, but not infection-unrelated, cancer among people with HIV infection than among uninfected people. The elevated rate of infection-related cancer in 2012-2020 highlights the importance of early and sustained antiretroviral therapy along with cancer screening and prevention measures.
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Affiliation(s)
- Ioana A Nicolau
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Rahim Moineddin
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Tony Antoniou
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Jennifer D Brooks
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Jennifer L Gillis
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Claire E Kendall
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Curtis Cooper
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Michelle Cotterchio
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Kate Salters
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Marek Smieja
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Abigail E Kroch
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Joanne D Lindsay
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Colleen Price
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Anthony Mohamed
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont
| | - Ann N Burchell
- Dalla Lana School of Public Health (Nicolau, Brooks, Cotterchio, Kroch), University of Toronto; Li Ka Shing Knowledge Institute (Nicolau, Antoniou, Lindsay, Mohamed, Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Moineddin, Antoniou, Burchell), University of Toronto; ICES Central (Moineddin, Antoniou, Burchell); Canadian Cancer Society (Gillis), Toronto, Ont.; Bruyère Research Institute (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute; ICES uOttawa (Kendall); Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University, Hamilton, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; Canadian HIV/AIDS and Chronic Pain Society (Price), Ottawa, Ont.
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14
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Huguet M, Navarro JT, Moltó J, Ribera JM, Tapia G. Diffuse Large B-Cell Lymphoma in the HIV Setting. Cancers (Basel) 2023; 15:3191. [PMID: 37370801 DOI: 10.3390/cancers15123191] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the widespread use of combined antiretroviral therapy (cART) and the subsequent decrease in AIDS-defining cancers, HIV-related lymphomas remain a leading cause of morbidity and mortality in people with HIV (PWH). Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL) subtype in PWH. This lymphoma is a heterogeneous disease including morphological variants and molecular subtypes according to the cell of origin or the mutation profile. In the pre-cART era, treatment with standard-dose chemotherapy induced high rates of toxicity and outcomes were very poor. The introduction of cART and the incorporation of infection prophylaxis allowed the use of conventional intensive chemotherapy regimens used in the general population, such as R-CHOP or R-EPOCH. The use of cART during chemotherapy treatment was initially controversial due to the potential risk of adverse drug-drug interactions. However, the availability of current cART regimens with less potential to cause drug interactions and evidence that cART improves survival rates in NHL strongly support the use of cART in PWH with DLBCL. Consequently, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PWH with NHL.
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Affiliation(s)
- Maria Huguet
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José-Tomás Navarro
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José Moltó
- Fundació Lluita Contra les Infeccions, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Josep-Maria Ribera
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - Gustavo Tapia
- Department of Pathology, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
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15
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Kayesh MEH, Kohara M, Tsukiyama-Kohara K. Toll-like Receptor Response to Human Immunodeficiency Virus Type 1 or Co-Infection with Hepatitis B or C Virus: An Overview. Int J Mol Sci 2023; 24:ijms24119624. [PMID: 37298575 DOI: 10.3390/ijms24119624] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
Toll-like receptors (TLRs) are evolutionarily conserved pattern recognition receptors that play important roles in the early detection of pathogen-associated molecular patterns and shaping innate and adaptive immune responses, which may influence the consequences of infection. Similarly to other viral infections, human immunodeficiency virus type 1 (HIV-1) also modulates the host TLR response; therefore, a proper understanding of the response induced by human HIV-1 or co-infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), due to the common mode of transmission of these viruses, is essential for understanding HIV-1 pathogenesis during mono- or co-infection with HBV or HCV, as well as for HIV-1 cure strategies. In this review, we discuss the host TLR response during HIV-1 infection and the innate immune evasion mechanisms adopted by HIV-1 for infection establishment. We also examine changes in the host TLR response during HIV-1 co-infection with HBV or HCV; however, this type of study is extremely scarce. Moreover, we discuss studies investigating TLR agonists as latency-reverting agents and immune stimulators towards new strategies for curing HIV. This understanding will help develop a new strategy for curing HIV-1 mono-infection or co-infection with HBV or HCV.
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Affiliation(s)
- Mohammad Enamul Hoque Kayesh
- Department of Microbiology and Public Health, Faculty of Animal Science and Veterinary Medicine, Patuakhali Science and Technology University, Barishal 8210, Bangladesh
| | - Michinori Kohara
- Department of Microbiology and Cell Biology, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Kyoko Tsukiyama-Kohara
- Transboundary Animal Diseases Centre, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima 890-0065, Japan
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16
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Henry V, Stephens MJ, Galyean P, Young J, Zickmund S, Knettel BA, Bartlett J, Watt MH, Pollak KI, Ubel PA, Fagerlin A, Suneja G. Improving Cancer Care for People Living With HIV: A Qualitative Study of Provider Knowledge, Attitudes, and Practice. Int J Radiat Oncol Biol Phys 2023; 116:60-67. [PMID: 36724857 PMCID: PMC11349291 DOI: 10.1016/j.ijrobp.2023.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023]
Abstract
PURPOSE Cancer is now the leading cause of non-AIDS death in the US population with HIV. People living with HIV (PLWH) are known to have lower cancer treatment rates and worse cancer outcomes. Disparate cancer treatment is driven by health system, patient, and clinician factors. Little attention has been given to the factors oncologists consider when making cancer treatment recommendations to PLWH. This study sought to examine oncologists' knowledge, attitudes, and practices that influence cancer treatment decision-making. METHODS AND MATERIALS This study used qualitative methods to explore oncologists' treatment decision-making processes for PLWH and cancer. The sample included 25 radiation, medical, and surgical oncologists from 2 academic centers and 5 community practices. The interview domains were developed from the Andersen Healthcare Utilization Model, the Health Belief Model, and the PEN-3 Model, as well as our prior survey research. RESULTS This study describes elements of cancer treatment decision-making for PLWH. Oncologists highlighted the need for formal HIV education to support cancer treatment. One main concern with patient-provider interactions pertained to maintaining patient confidentiality during clinical encounters. Lastly, the importance of multidisciplinary care among health care providers allowed oncologists to facilitate both cancer care and logistical support. CONCLUSIONS As cancer becomes an increasingly common cause of death among PLWH, it is critical to understand the drivers of the observed disparities in cancer treatment. To our knowledge, this is the first qualitative study to describe oncologists' knowledge, attitudes, and practices toward patients who have a comorbid diagnosis of HIV and cancer. Several themes for future interventions emerge, including HIV training for cancer care providers, fostering interdisciplinary collaboration, enhancing HIV education for oncology learners and clinicians, and minimizing implicit bias.
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Affiliation(s)
- Valencia Henry
- Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina
| | - Maya J Stephens
- Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Patrick Galyean
- Division of Epidemiology, University of Utah, Salt Lake City, Utah
| | - Jeanette Young
- Division of Epidemiology, University of Utah, Salt Lake City, Utah
| | - Susan Zickmund
- Division of Epidemiology, University of Utah, Salt Lake City, Utah
| | - Brandon A Knettel
- Duke Global Health Institute, Duke University, Durham, North Carolina; Duke University School of Nursing, Duke University, Durham, North Carolina
| | - John Bartlett
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Melissa H Watt
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kathryn I Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina; Cancer Prevention and Control, Duke Cancer Institute, Durham, North Carolina
| | - Peter A Ubel
- Fuqua School of Business, Duke University, Durham, North Carolina
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah; Salt Lake City VA Center for Informatics, Decision Enhancement and Surveillance (IDEAS), Salt Lake City, Utah
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
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Nkwonta CA, Zhang J, Chen S, Weissman S, Olatosi B, Li X. Prevalence and trend of AIDS-defining cancers and non-AIDS-defining cancers and their association with antiretroviral therapy among people living with HIV in South Carolina: a population-based cohort study. AIDS Care 2023; 35:753-763. [PMID: 35578401 PMCID: PMC9666704 DOI: 10.1080/09540121.2022.2074957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
ABSTRACTMonitoring cancer trends and risk is critical as cancer remains a growing problem in persons living with HIV (PLWH). Recent population-based data are limited regarding the cancer trends among PLWH. Our study examined the prevalence and trends in the rate of AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC) and their risk factors in PLWH in South Carolina. Utilizing linked population-based HIV data (2005-2020), time-dependent proportional hazards model was used to identify associated risk predictors of developing cancer in PLWH. Among 11,238 PLWH, 250 individuals developed ADC and 454 developed NADC. The median time from HIV diagnosis to cancer diagnosis was 1.9 years for ADC and 3.8 years for NADC. Individuals who developed ADC or NADC were more likely to be older, male, use substances, have hepatitis infection, hypothyroidism, hypertension, and renal disease. Individuals with viral load >100,000 copies/ml were more likely to develop ADC while those with CD4 count >350 cells/mm3 were less likely to develop ADC or NADC. Our findings suggest that long-term viral suppression may contribute to risk reduction for cancer in PLWH. Early HIV diagnosis along with viral load suppression should be a part of ongoing cancer prevention efforts.
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Affiliation(s)
- Chigozie A. Nkwonta
- Rory Meyers College of Nursing, New York University, New York, NY, USA, 10010
| | - Jiajia Zhang
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA, 29208
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Shujie Chen
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA, 29208
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Sharon Weissman
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA, 29208
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA, 29208
| | - Bankole Olatosi
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
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18
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Bickford DD, Johnson P, Brahmbhatt N, Kroft S. Cervical Syphilitic Lymphadenitis in a 29-Year-Old Female: A Case Report. Cureus 2023; 15:e36065. [PMID: 37056520 PMCID: PMC10092898 DOI: 10.7759/cureus.36065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2023] [Indexed: 03/16/2023] Open
Abstract
Cervical lymphadenopathy is a common condition characterized by the enlargement of lymph nodes. It can have various causes, including infections, inflammatory conditions, and neoplastic processes. Syphilis, a sexually transmitted disease that progresses through multiple stages, can also be a rare cause of cervical lymphadenopathy, particularly in HIV-positive individuals. In this case report, we describe a patient presenting with throat pain, systemic symptoms, and cervical lymphadenopathy, initially clinically suggestive of lymphoma but ultimately determined to be caused by syphilis of unknown duration. This case highlights the importance of considering syphilis in the differential diagnosis of cervical lymphadenitis, particularly in patients with risk factors, such as intravenous drug use and HIV infection, and the need for a thorough evaluation of the patient's social and medical histories to diagnose and treat the condition accurately.
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19
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Matute Mizger V, Martínez Sánchez LM. Quimioterapia en linfoma y su estrecha relación con el virus de la inmunodeficiencia humana /síndrome de inmunodeficiencia adquirida. REPERTORIO DE MEDICINA Y CIRUGÍA 2023. [DOI: 10.31260/repertmedcir.01217372.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
El virus de la inmunodeficiencia humana (VIH) ha estado en nuestra sociedad durante muchos años y los casos han aumentado con el paso del tiempo. La inmunosupresión y el síndrome de inmunodeficiencia adquirida (SIA) predisponen en gran parte al desarrollo de diferentes enfermedades, como el linfoma. Objetivo: realizar una revisión acerca de la quimioterapia en el linfoma asociado con el virus de la inmunodeficiencia humana y el síndrome de inmunodeficiencia adquirida, y su predisposición a sufrir más enfermedades oportunistas. Métodos: se realizó una revisión de la literatura en las bases de datos PubMed y ScienceDirect, con los descriptores “infecciones”, “linfoma”, “neoplasias”, “quimioterapia”, “serodiagnóstico del SIDA”, en inglés y español, seleccionando 10 artículos relacionados. Conclusión: la inmunosupresión que genera este virus puede predisponer en gran medida al desarrollo de muchas neoplasias en especial el linfoma. A pesar de que la quimioterapia es el tratamiento más efectivo en este tipo de pacientes, exacerba la condición de base de las personas y los hace más susceptibles a padecer infecciones oportunistas, las cuales pueden empeorar su situación, considerando así la quimioterapia como un factor de riesgo.
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20
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Diakite M, Shaw-Saliba K, Lau CY. Malignancy and viral infections in Sub-Saharan Africa: A review. FRONTIERS IN VIROLOGY (LAUSANNE, SWITZERLAND) 2023; 3:1103737. [PMID: 37476029 PMCID: PMC10358275 DOI: 10.3389/fviro.2023.1103737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The burden of malignancy related to viral infection is increasing in Sub-Saharan Africa (SSA). In 2018, approximately 2 million new cancer cases worldwide were attributable to infection. Prevention or treatment of these infections could reduce cancer cases by 23% in less developed regions and about 7% in developed regions. Contemporaneous increases in longevity and changes in lifestyle have contributed to the cancer burden in SSA. African hospitals are reporting more cases of cancer related to infection (e.g., cervical cancer in women and stomach and liver cancer in men). SSA populations also have elevated underlying prevalence of viral infections compared to other regions. Of 10 infectious agents identified as carcinogenic by the International Agency for Research on Cancer, six are viruses: hepatitis B and C viruses (HBV and HCV, respectively), Epstein-Barr virus (EBV), high-risk types of human papillomavirus (HPV), Human T-cell lymphotropic virus type 1 (HTLV-1), and Kaposi's sarcoma herpesvirus (KSHV, also known as human herpesvirus type 8, HHV-8). Human immunodeficiency virus type 1 (HIV) also facilitates oncogenesis. EBV is associated with lymphomas and nasopharyngeal carcinoma; HBV and HCV are associated with hepatocellular carcinoma; KSHV causes Kaposi's sarcoma; HTLV-1 causes T-cell leukemia and lymphoma; HPV causes carcinoma of the oropharynx and anogenital squamous cell cancer. HIV-1, for which SSA has the greatest global burden, has been linked to increasing risk of malignancy through immunologic dysregulation and clonal hematopoiesis. Public health approaches to prevent infection, such as vaccination, safer injection techniques, screening of blood products, antimicrobial treatments and safer sexual practices could reduce the burden of cancer in Africa. In SSA, inequalities in access to cancer screening and treatment are exacerbated by the perception of cancer as taboo. National level cancer registries, new screening strategies for detection of viral infection and public health messaging should be prioritized in SSA's battle against malignancy. In this review, we discuss the impact of carcinogenic viruses in SSA with a focus on regional epidemiology.
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Affiliation(s)
- Mahamadou Diakite
- University Clinical Research Center, University of Sciences, Techniques, and Technologies, Bamako, Mali
| | - Kathryn Shaw-Saliba
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Chuen-Yen Lau
- HIV Dynamics and Replication Program, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, United States
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Abstract
PURPOSE OF REVIEW As people living with human immunodeficiency virus (HIV, PLWH) age, aging-related comorbidities have come into focus as major challenges to their overall health. In this review, an in-depth overview of the two most commonly encountered chronic lung diseases in PLWH, chronic obstructive pulmonary disease (COPD) and lung cancer, is provided. RECENT FINDINGS The risk for both COPD and lung cancer remains significantly higher in PLWH compared to the HIV-uninfected population, although fortunately rates of lung cancer appear to be declining over the last two decades. Outcomes for PLWH with these conditions, though, continue to be poor with worse survival rates in comparison to the general population. PLWH still face major barriers in accessing care for these conditions, including a higher likelihood of being underdiagnosed with COPD and a lower likelihood of being referred for lung cancer screening or treatment. A lack of evidence for optimal treatment strategies for both COPD and lung cancer still hampers the care of PLWH with these conditions. SUMMARY COPD and lung cancer represent substantial burdens of disease in PLWH. Improved access to standard-of-care screening and treatment and greater investigation into therapeutic responses specifically in this population are recommended.
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Affiliation(s)
- Janice M Leung
- Division of Respiratory Medicine, Department of Medicine
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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22
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Yuan R, Zhang Y, Deng L, Yu X, Zhuang K, Chen X, Cao Q, Ping H, Ke H, Gui X, Yang R. A novel plasma proteomic-based model for predicting liver fibrosis in HIV/HBV co-infected adults. J Med Virol 2023; 95:e28222. [PMID: 36237173 DOI: 10.1002/jmv.28222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 01/11/2023]
Abstract
To establish a plasma model to predict the risk of liver fibrosis in HIV/HBV co-infected individuals. Quantitative liquid chromatography-tandem mass spectrometry(LC-MS/MS) was used to identify differentially expressed proteins (DEPs) in plasma collected from HIV/HBV co-infected individuals with and without liver fibrosis. In total, 97 DEPs were identified, among which 11 were further validated as potential biomarkers, with immunoglobulin and complement components being the most common proteins. These markedly altered proteins were found to mediate pathophysiological pathways, including humoral immune response, complement and coagulation cascades, and complement activation. A visual logistic model, in which immunoglobulin heavy variable 3-20 (IGHV3-20), immunoglobulin heavy variable 1-24 (IGHV1-24), and macrophage colony-stimulating factor 1 receptor (CSF1R) proteins were included, has been established to predict liver fibrosis in HIV/HBV co-infected individuals. The preliminary conclusion showed that the combination of IGHV3-20, IGFHV1-24, and CSF1R is expected to become a predictive model for liver fibrosis in the context of HIV/HBV co-infection and a further validation should be performed.
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Affiliation(s)
- Rui Yuan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yongxi Zhang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liping Deng
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xingxia Yu
- Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ke Zhuang
- ABSL-III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
| | - Xiaoping Chen
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Qian Cao
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haiqin Ping
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hengning Ke
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xien Gui
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Rongrong Yang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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23
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Olusanya OA, Tomar A, Thomas J, Johnson P, Wigfall LT. HPV-Associated Anal Cancer Knowledge, Attitudes, and Health Communication Behaviors Among Non-clinical Providers at HIV/AIDS Service Organizations in Southern United States Region. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1886-1892. [PMID: 34148218 PMCID: PMC8685300 DOI: 10.1007/s13187-021-02056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 06/12/2023]
Abstract
Co-infection with HIV/HPV and bio-behavioral risk factors (e.g., immunodeficiency, un-protected sex) increase likelihood for developing anal and other HPV-associated cancers among people living with HIV/AIDS (PLWHA). We explored knowledge, attitudes, and health communication regarding HPV-associated anal cancers among HIV/AIDS service organization (ASO) employees/volunteers delivering non-clinical services to PLWHA. Participants (n=59) were recruited from six ASOs located in the South United States Census region and completed a 118-item self-administered survey. For current analyses, outcome measures were knowledge, attitudes, and health communication regarding anal cancer. Descriptive statistics assessed outcome measures which were subsequently dichotomized into binary variables (i.e., high/favorable or low/unfavorable). Fisher's exact test examined associations between outcome measures and ASO employees/volunteers' sex/sexual orientation (i.e., heterosexual female, heterosexual male, LGBTI female, LGBTI male). Mean age for ASO employees/volunteers was 45.5 years (±13.5 SD). Participants were heterosexual females (45.7%), LGBTI males (27.3%), heterosexual males (13.5%), and LGBTI females (13.5%). Almost half (44.8%) had not heard about anal Pap screening and 39.0% did not think HPV can cause anal cancer. Overall, 73.9% had low knowledge scores. Participants (47.4%) were unsure or believed HPV vaccinations were non-protective against anal cancer while 94.9% had favorable health communication behaviors. Knowledge regarding anal cancer being linked to HPV (p=0.006) and health information seeking on anal cancer (p=0.000) were statistically significantly different by sex/sexual orientation. Fostering increased knowledge, favorable attitudes, and improved health communication behaviors among ASO employees/volunteers could facilitate dissemination and promotion of anal cancer prevention strategies (anal Pap screenings, HPV vaccinations) among PLWHA.
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Affiliation(s)
- Olufunto A Olusanya
- UTHSC-Oak Ridge National Laboratory Center for Biomedical Informatics, Department of Pediatrics, Le Bonheur Research Center, University of Tennessee Health Science Center (UTHSC), 50 N Dunlap, Memphis, TN, 38103, USA.
| | - Aditi Tomar
- Department of Health and Kinesiology, Texas A&M University, 107 Gilchrist Building (Reception Area), Mail Stop 4243, College Station, Texas, TX, 77842-4243, USA
| | - Jonathan Thomas
- Department of Public Health Studies, Texas A&M School of Public Health, 212 Adriance Lab Rd, College Station, Texas, TX, 77843, USA
| | - Praisy Johnson
- Department of Public Health Studies, Texas A&M School of Public Health, 212 Adriance Lab Rd, College Station, Texas, TX, 77843, USA
| | - Lisa T Wigfall
- Cancer Prevention Research Training Program, The University of Texas MD Anderson Cancer Center, 1150 Pressler Street, Cancer Prevention Research Building (CPB7.3556), Houston, TX, 77030, USA
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Abstract
The human papillomavirus (HPV) E6 and E7 oncogenes are expressed at all stages of HPV-mediated carcinogenesis and are essential drivers of cancers caused by high-risk HPV. Some of the activities of HPV E6 and E7, such as their interactions with host cellular tumor suppressors, have been characterized extensively. There is less information about how high-risk HPV E6 and E7 alter cellular responses to cytokines that are present in HPV-infected tissues and are an important component of the tumor microenvironment. We used several models of HPV oncoprotein activity to assess how HPV16 E6 and E7 alter the cellular response to the proinflammatory cytokine IL-1β. Models of early stage HPV infection and of established HPV-positive head and neck cancers exhibited similar dysregulation of IL-1 pathway genes and suppressed transcriptional responses to IL-1β treatment. Such overlap in cell responses supports that changes induced by HPV16 E6 and E7 early in infection could persist and contribute to a dysregulated immune environment throughout carcinogenesis. HPV16 E6 and E7 also drove the upregulation of several suppressors of IL-1 cytokine signaling, including SIGIRR, both in primary keratinocytes and in cancer cells. SIGIRR knockout was insufficient to increase IL-1β-dependent gene expression in the presence of HPV16 E6 and E7, suggesting that multiple suppressors of IL-1 signaling contribute to dampened IL-1 responses in HPV16-positive cells. IMPORTANCE Human papillomavirus (HPV) infection is responsible for nearly 5% of the worldwide cancer burden. HPV-positive tumors develop over years to decades in tissues that are subject to frequent stimulation by proinflammatory cytokines. However, the effects of HPV oncoproteins on the cellular response to cytokine stimulation are not well defined. We analyzed IL-1 cytokine signaling in several models of HPV biology and disease. We found that HPV16 E6 and E7 oncoproteins mediate a broad and potent suppression of cellular responses to IL-1β in models of both early and late stages of carcinogenesis. Our data provide a resource for future investigation of IL-1 signaling in HPV-positive cells and cancers.
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Yuan T, Hu Y, Zhou X, Yang L, Wang H, Li L, Wang J, Qian HZ, Clifford GM, Zou H. Incidence and mortality of non-AIDS-defining cancers among people living with HIV: A systematic review and meta-analysis. EClinicalMedicine 2022; 52:101613. [PMID: 35990580 PMCID: PMC9386399 DOI: 10.1016/j.eclinm.2022.101613] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Non-AIDS-defining cancers (NADCs) are now becoming a rising cause of morbidity among people living with HIV (PLHIV) in the highly active antiretroviral therapy (HAART) era. We conducted a systematic review and meta-analysis to estimate the summary risk of incidence and mortality of a wide range of NADCs among PLHIV compared with the general population. Methods This systematic review and meta-analysis was registered in the PROSPERO (registration number CRD42020222020). We searched PubMed, EMBASE, Cochrane library, and Web of Science for relevant studies published before Jan 24, 2022. Cohort or registry linkage studies comparing the incidence or mortality of individual NADCs in PLHIV with that in the general population were included. Studies simply reporting outcomes of cancer precursor lesions or combined NADCs were excluded. We calculated pooled standardised incidence (SIRs) and standardised mortality ratios (SMRs) and their 95% confidence intervals (CIs) using random-effects models, and used robust variance estimation to account for non-independence in study-level effect sizes. Findings We identified 92 publications arising from 46 independent studies including 7 articles out of 7 studies from developing countries. Among the 40 types of NADCs investigated, all of the 20 infection-related NADCs, cancers related with human papillomavirus infection in particular, and half of the 20 non-infection-related NADCs occurred in excess in PLHIV compared with the general population. This risk pattern was consistent in most WHO regions and in both high-income and low-and middle-income countries. The increased SIRs for various NADCs were more evident among PLHIV with advanced immunodeficiency, and was explored by HIV transmission route, and use of HAART. PLHIV had increased mortality for anal cancer (SMR 124·07, 95% CI 27·31-563·72), Hodgkin lymphoma (41·03, 2·91-577·88), liver cancer (8·36, 3·86-18·11), lung cancer (3·95, 1·52-10·26), and skin melanoma (3·95, 1·28-12·2). Interpretation PLHIV had increased incidence and mortality for a wide spectrum of NADCs. Primary prevention and effective treatment for NADCs in this population is urgently needed. Funding Natural Science Foundation of China Excellent Young Scientists Fund, Natural Science Foundation of China International/Regional Research Collaboration Project, National Science and Technology Major Project of China, Sanming Project of Medicine in Shenzhen, High Level Project of Medicine in Longhua, Shenzhen, Shenzhen Science and Technology Innovation Commission Basic Research Program, Special Support Plan for High-Level Talents of Guangdong Province, the Guangzhou Basic Research Program on People's Livelihood Science and Technology, the National Natural Science Foundation of China.
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Affiliation(s)
- Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Luoyao Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Wang
- National Clinical Research Center for Infectious Diseases, Shenzhen, China
- The Third People's Hospital of Shenzhen, Shenzhen, China
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Linghua Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou, China
- Guangzhou Medical University, Guangzhou, China
| | - Junfeng Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Han-Zhu Qian
- School of Public Health, Yale University, New Haven, CT USA
| | - Gary M. Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Kirby Institute, the University of New South Wales, Sydney, Australia
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Park B, Ahn KH, Choi Y, Kim JH, Seong H, Kim YJ, Choi JY, Song JY, Lee E, Jun YH, Yoon YK, Choi WS, Lee M, Seong J, Kim SW. Cancer Incidence Among Adults With HIV in a Population-Based Cohort in Korea. JAMA Netw Open 2022; 5:e2224897. [PMID: 35917123 PMCID: PMC9346552 DOI: 10.1001/jamanetworkopen.2022.24897] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In combination with a decreased risk of AIDS-defining cancers and improved survival of people infected with HIV, the burden of non-AIDS-defining cancer has increased markedly. Although a substantial number of studies have measured the cancer risk among people with HIV in developed countries, little research has been conducted on the risk of cancer in HIV-infected people in Asia. OBJECTIVE To examine the cancer incidence and the estimated risk of cancer among people in Korea infected with HIV compared with the general population. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study evaluated patients without cancer newly diagnosed with HIV from January 1, 2006, to December 31, 2018, using a nationwide population-based claims database embedded in the National Health Insurance Service database. Data were analyzed between December 6, 2021, and February 28, 2022. EXPOSURES Infection with HIV. MAIN OUTCOMES AND MEASURES Cancer incidence and standardized incidence rate (SIR) through indirect standardization. RESULTS A total of 11 552 individuals without cancer (10 444 male [90.4%]; mean [SD] age, 39.9 [11.2] years) diagnosed with HIV were identified. The SIR for all cancers was 1.68 (95% CI, 1.50-1.87) in men and 1.26 (95% CI, 0.89-1.64) in women. In men, the highest SIRs were for Kaposi sarcoma (SIR, 349.10; 95% CI, 196.10-502.20) and anal cancer (SIR, 104.20; 95% CI, 55.56-149.90). The incidence of non-Hodgkin lymphoma (SIR, 15.62; 95% CI, 11.85-19.39), Hodgkin lymphoma (SIR, 16.67; 95% CI, 4.32-29.02), and oropharyngeal cancer (SIR, 2.97; 95% CI, 1.36-4.58) in men infected with HIV was higher than in the general population. In women infected with HIV, an increased incidence of cervical cancer (SIR, 4.98; 95% CI, 1.29-8.66) and non-Hodgkin lymphoma (SIR, 11.78; 95% CI, 2.35-21.21) compared with the general population was observed. The SIR of thyroid cancer in patients with HIV was lower than in the general population in both men (SIR, 0.63; 95% CI, 0.27-0.99) and women (SIR, 0.48; 95% CI, 0.06-0.90). CONCLUSIONS AND RELEVANCE In this cohort study, cancer risks, especially AIDS-defining cancer and virus-related cancer, were elevated in people with HIV. Efforts for cancer prevention, screening, and better accessibility to medical care in HIV-infected people are warranted.
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Affiliation(s)
- Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Hwan Ahn
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yunsu Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jung Ho Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Seong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youn Jeong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Jun Young Choi
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Yoon Hee Jun
- Division of Infectious Disease, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Won Suk Choi
- Division of Infectious Disease, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Myungsun Lee
- Division of Clinical Research, Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Jaehyun Seong
- Division of Clinical Research, Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Nicolau IA, Antoniou T, Brooks JD, Moineddin R, Cooper C, Cotterchio M, Gillis JL, Kendall CE, Kroch AE, Lindsay JD, Price C, Salters K, Smieja M, Burchell AN. The burden of cancer among people living with HIV in Ontario, Canada, 1997-2020: a retrospective population-based cohort study using administrative health data. CMAJ Open 2022; 10:E666-E674. [PMID: 35853661 PMCID: PMC9312995 DOI: 10.9778/cmajo.20220012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND With combination antiretroviral therapy (ART) and increased longevity, cancer is a leading cause of morbidity among people with HIV. We characterized trends in cancer burden among people with HIV in Ontario, Canada, between 1997 and 2020. METHODS We conducted a population-based, retrospective cohort study of adults with HIV using linked administrative health databases from Jan. 1, 1997, to Nov. 1, 2020. We grouped cancers as infection-related AIDS-defining cancers (ADCs), infection-related non-ADCs (NADCs) and infection-unrelated cancers. We calculated age-standardized incidence rates per 100 000 person-years with 95% confidence intervals (CIs) using direct standardization, stratified by calendar period and sex. We also calculated limited-duration prevalence. RESULTS Among 19 403 adults living with HIV (79% males), 1275 incident cancers were diagnosed. From 1997-2000 to 2016- 2020, we saw a decrease in the incidence of all cancers (1113.9 [95% CI 657.7-1765.6] to 683.5 [95% CI 613.4-759.4] per 100 000 person-years), ADCs (403.1 [95% CI 194.2-739.0] to 103.8 [95% CI 79.2-133.6] per 100 000 person-years) and infection-related NADCs (196.6 [95% CI 37.9-591.9] to 121.9 [95% CI 94.3-154.9] per 100 000 person-years). The incidence of infection-unrelated cancers was stable at 451.0 per 100 000 person-years (95% CI 410.3-494.7). The incidence of cancer among females increased over time but was similar to that of males in 2016-2020. INTERPRETATION Over a 24-year period, the incidence of cancer decreased overall, largely driven by a considerable decrease in the incidence of ADC, whereas the incidence of infection-unrelated cancer remained unchanged and contributed to the greatest burden of cancer. These findings could reflect combination ART-mediated changes in infectious comorbidity and increased life expectancy; targeted cancer screening and prevention strategies are needed.
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Affiliation(s)
- Ioana A Nicolau
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Tony Antoniou
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Jennifer D Brooks
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Rahim Moineddin
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Curtis Cooper
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Michelle Cotterchio
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Jennifer L Gillis
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Claire E Kendall
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Abigail E Kroch
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Joanne D Lindsay
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Colleen Price
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Kate Salters
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Marek Smieja
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont
| | - Ann N Burchell
- Division of Epidemiology Toronto (Nicolau, Brooks, Cotterchio, Gillis, Burchell, Dalla Lana School of Public Health, University of Toronto; ICES Central (Antoniou, Moineddin, Kendall, Burchell); Unity Health Toronto (Antoniou, Lindsay, Burchell), St Michael's Hospital; Department of Family and Community Medicine (Moineddin, Burchell), University of Toronto, Toronto, Ont.; Ottawa Hospital Research Institute (Cooper), Ottawa, Ont.; Ontario Health (Cancer Care Ontario) (Cotterchio), Toronto, Ont.; Department of Medicine (Gillis), School of Population and Public Health, University of British Columbia, Vancouver, BC; Bruyère Research Institute (Kendall); ICES uOttawa (Kendall); Department of Family Medicine (Kendall), University of Ottawa; Institut du Savoir Montfort (Kendall); Clinical Epidemiology Program (Kendall), Ottawa Hospital Research Institute, Ottawa, Ont.; Ontario HIV Treatment Network (Kroch), Toronto, Ont.; CIHR Canadian HIV Trials Network - Chronic Pain and HIV Working Group (Price); British Columbia Centre for Excellence in HIV/AIDS (Salters), Vancouver, BC; Department of Pathology and Molecular Medicine (Smieja), McMaster University (Smieja), Hamilton, Ont.
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28
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Lee SO, Lee JE, Lee S, Lee SH, Kang JS, Son H, Lee H, Kim J. Nationwide population-based incidence of cancer among patients with HIV/AIDS in South Korea. Sci Rep 2022; 12:9974. [PMID: 35705675 PMCID: PMC9200856 DOI: 10.1038/s41598-022-14170-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 06/02/2022] [Indexed: 12/25/2022] Open
Abstract
Cancers are the leading cause of death among people living with HIV/AIDS (PLWHA); however, nationwide studies on cancer incidence are limited. We aimed to determine the trends in the incidence rates of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) among Korean PLWHA. Data from the National Health Insurance Sharing Service from 2004 to 2017 were collected. Age- and sex-adjusted standardized incidence ratios (SIRs) for various cancer types relative to the general population were calculated. Of the 11,737 PLWHA followed-up for 65,052 person-years (PYs), 445 (ADCs, 130 and NADCs, 298) developed cancer. The incidence rate of ADCs decreased, whereas that of NADCs remained unchanged. PLWHA were at an increased risk of ADCs (SIR: 12.6, 95% CI: 10.6–15.0), including Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical cancer, and some NADCs, including anal cancer, lung cancer, liver cancer, and oropharyngeal cancer. Of the 396 patients who received antiretroviral therapy (ART), 215 with optimal adherence had lower incidence rates for ADCs and NADCs than those with non-optimal adherence. The 5-year survival rate of PLWHA with NADCs was 57.8%. Close surveillance and routine screening of cancers and improvement in ART adherence are required to improve the clinical outcomes of PLWHA.
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Affiliation(s)
- Soon Ok Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Jeong Eun Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Shinwon Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea.
| | - Jin Suk Kang
- Department of Internal Medicine, Inje University School of Medicine, Busan Paik Hospital, Busan, Korea
| | - Hyunjin Son
- Department of Prevention Medicine, Donga University School of Medicine, Donga University Hospital, Busan, Korea
| | - Hyungi Lee
- Department of Statistics, Biomedical Institution, Pusan National University Hospital, Busan, Korea
| | - Jinmi Kim
- Department of Statistics, Biomedical Institution, Pusan National University Hospital, Busan, Korea
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Tassachew Y, Abebe T, Belyhun Y, Teffera T, Shewaye AB, Desalegn H, Andualem H, Kinfu A, Mulu A, Mihret A, Howe R, Aseffa A. Prevalence of HIV and Its Co-Infection with Hepatitis B/C Virus Among Chronic Liver Disease Patients in Ethiopia. Hepat Med 2022; 14:67-77. [PMID: 35591850 PMCID: PMC9113656 DOI: 10.2147/hmer.s365443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/06/2022] [Indexed: 12/11/2022] Open
Abstract
Background The efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however, mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV. Objective The study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver disease (CLD) patients in Ethiopia. Methods Three hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC) (n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV testing algorithm was employed to screen HIV infection. Results Regardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were co-infected with HBV (HBsAg+HBcAb+) and HCV (anti-HCV+ HCV-RNA+), respectively, and 86.7% (13/15) exhibited a marker of HBV exposure (total HBcAb+). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than non-HCC patients [8.6% (11/128) vs 1.8 (4/217), p=0.005 and 3.9% (5/128) vs 0.9% (2/217), p=0.1]. The rate of HIV mono-infection was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients. Conclusion The frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in people living with HIV.
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Affiliation(s)
- Yayehyirad Tassachew
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.,School of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Tamrat Abebe
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yeshambel Belyhun
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tezazu Teffera
- Department of Surgery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Abate Bane Shewaye
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Adera Medical Center PLC, Addis Ababa, Ethiopia
| | - Hailemichael Desalegn
- Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Henok Andualem
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abiy Kinfu
- Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia
| | | | - Adane Mihret
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Rawleigh Howe
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
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30
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DiMaio D, Emu B, Goodman AL, Mothes W, Justice A. Cancer Microbiology. J Natl Cancer Inst 2022; 114:651-663. [PMID: 34850062 PMCID: PMC9086797 DOI: 10.1093/jnci/djab212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/18/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022] Open
Abstract
Microbes play important roles in cancer from direct carcinogenic effects to their use in treatment. Cancers caused by microorganisms account for approximately 15% of cancers, primarily in low- and middle-income countries. Unique features of infectious carcinogens include their transmissibility, mutability, and specific immune interactions, which provide challenges and opportunities for cancer prevention and treatment. For these agents, infection control through exposure reduction, antivirals, antibiotics, and vaccines is cancer control. In addition, developing evidence suggests that microorganisms including the human microbiome can indirectly modulate cancer formation and influence the effectiveness and toxicity of cancer treatments. Finally, microorganisms themselves can be used to prevent or treat cancer. The convergence of these factors signals the emergence of a new field, cancer microbiology. Recognition of cancer microbiology will spur research, stimulate cross-disciplinary training, inform drug development, and improve public health.
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Affiliation(s)
- Daniel DiMaio
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA
- Department of Molecular Biophysics & Biochemistry, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Brinda Emu
- Yale Cancer Center, New Haven, CT, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Andrew L Goodman
- Yale Cancer Center, New Haven, CT, USA
- Department of Microbial Pathogenesis, Yale University, New Haven, CT, USA
| | - Walther Mothes
- Yale Cancer Center, New Haven, CT, USA
- Department of Microbial Pathogenesis, Yale University, New Haven, CT, USA
| | - Amy Justice
- Yale Cancer Center, New Haven, CT, USA
- Department of General Medicine, Yale University, VA Medical Center, New Haven, CT, USA
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Chaussade H, Le Marec F, Coureau G, Leleux O, Neau D, Lazaro E, Amadeo B, Duffau P, Ferrand H, Courtault C, Foucan AS, Wittkop L, Bonnet F. Incidence of lung and human papilloma virus-associated malignancies in HIV-infected patients. AIDS 2022; 36:665-673. [PMID: 34923517 DOI: 10.1097/qad.0000000000003152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cancers represent one of the leading cause of mortality/morbidity in patients with HIV (PWH) in industrialized countries. The objective of our study was to compare incidence of lung and human papilloma virus (HPV)-related cancers among PWH with general population over the 2010-2017 period. DESIGN Prospective and multicenter cohort study. METHODS The study included patients with lung and HPV-related cancers from the ANRS CO3 Aquitaine cohort (PWH) and the general population-based cancer registry in Gironde area. We calculated incidence rates for 100 000 person-years and incidence rate ratios (IRR). RESULTS Among the 3572 PWH, 70 cancers were diagnosed in 68 patients including 35 lung and 35 HPV-related cancers (18 oropharyngeal, 11 anal, 6 cervix). Incidence rates of lung and HPV-related-cancers were 311.1 in PWH and 209.8 in general population for 100 000 person-years, respectively. IRR were significantly increased in PWH for lung 1.8 [1.4-2.2] and HPV-related cancer 1.3 [1.0-1.6] and particularly high for patients between 40 and 49 years old [IRR 4.4 (2.3-8.4) for lung cancer and 3.7 (2.1-6.5) for HPV-related cancer]. CONCLUSION We emphasized the persistent high risk of lung and HPV-related cancer despite advent of antiretroviral therapies, particularly in the age strata of 40-49 years. Screening procedures should take into account this finding.
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Affiliation(s)
- Hélène Chaussade
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
| | - Fabien Le Marec
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Gaëlle Coureau
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Olivier Leleux
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Didier Neau
- CHU Bordeaux, Service des maladies infectieuses et tropicales, Bordeaux
| | - Estibaliz Lazaro
- CHU Bordeaux, Services de médecine interne et maladies infectieuses, Pessac
| | - Brice Amadeo
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Pierre Duffau
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
| | | | - Carine Courtault
- Service de médecine interne et maladies infectieuses, Arcachon, France
| | - Anne-Sophie Foucan
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Linda Wittkop
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Fabrice Bonnet
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
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Rojas Rojas T, Poizot-Martin I, Rey D, Duvivier C, Bani-Sadr F, Cabie A, Delobel P, Jacomet C, Allavena C, Ferry T, Pugliese P, Valantin MA, Lamaury I, Hustache-Matthieu L, Fresard A, Houyou T, Huleux T, Cheret A, Makinson A, Obry-Roguet V, Lions C, Carrieri MP, Protopopescu C, the Dat’AIDS Study Group. Incidence of cervical, breast and colorectal cancers between 2010 and 2015 in people living with HIV in France. PLoS One 2022; 17:e0261069. [PMID: 35333883 PMCID: PMC8956191 DOI: 10.1371/journal.pone.0261069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program. SETTING This is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort. METHODS Standardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection. RESULTS The 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73). CONCLUSION The present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.
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Affiliation(s)
- Teresa Rojas Rojas
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Isabelle Poizot-Martin
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - David Rey
- Le Trait d’Union, HIV-Infection Care Center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker-Pasteur, IHU Imagine, Paris, France
- Institut Cochin—CNRS 8104—INSERM U1016—RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France
- Centre Médical de l’Institut Pasteur, Institut Pasteur, Paris, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - André Cabie
- Université des Antilles, CHU de Martinique, Fort-de-France, Martinique, France
| | - Pierre Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales-INSERM, UMR 1043- Université Toulouse III Paul Sabatier, Toulouse, France
| | - Christine Jacomet
- Clermont-Ferrand University Hospital Infectious and Tropical disease Department, Clermont Ferrand, France
| | - Clotilde Allavena
- Infectious Diseases Department, CHU Hôtel-Dieu, INSERM UIC 1413, CHU Nantes, Nantes, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | - Marc-Antoine Valantin
- GHPS Pitié Salpêtrière APHP, Infectious Diseases, Paris, France
- Sorbonne Universités UPMC Université Paris 6-INSERM-IPLESP, Paris, France
| | - Isabelle Lamaury
- Department of Infectious and Tropical Diseases, University Hospital of Pointe-à-Pitre, Pointe-à-Pitre, France
| | | | - Anne Fresard
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Tamazighth Houyou
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Thomas Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur—Centre Hospitalier G. DRON Tourcoing, Tourcoing, France
| | - Antoine Cheret
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Internal Medicine, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Alain Makinson
- Department of Infectious Diseases, Montpellier University Hospital, INSERM U1175/IRD UMI 233, Montpellier, France
| | - Véronique Obry-Roguet
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Caroline Lions
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Maria Patrizia Carrieri
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Camelia Protopopescu
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
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Malmström S, Wagner P, Yilmaz A, Svedhem V, Carlander C. Failure to restore CD4+ cell count associated with infection-related and noninfection-related cancer. AIDS 2022; 36:447-457. [PMID: 34711738 DOI: 10.1097/qad.0000000000003117] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess incidence and relative risk of cancer in Sweden, by HIV status, from 1988 to 2017. DESIGN Population-based register study. METHODS From the Swedish Total Population Register, all people born between 1940 and 2000 (n = 8 587 629), and resident in Sweden sometime 1983-2017 were identified and linked to National HIV Register InfCareHIV, National Cancer Register, and LISA database. We present incidence and adjusted hazard ratios (adjHR) of infection and noninfection-related cancer for three periods between 1988 and 2017. RESULTS Incidence and relative risk of infection-related cancer decreased but remained higher in people with HIV (PWH) than in HIV-negative. The proportion attributable to infection remained higher in PWH than in HIV-negative (44 vs. 9%). Women with HIV had lower risk of infection-related cancer than men with HIV [adjusted hazard ratio (adjHR) 0.6, 95% CI 0.4-0.9], mainly driven by lower incidence of Kaposi's sarcoma (adjHR 0.1, 95% CI 0.0-0.4). Current viral suppression (adjHR 0.3, 95% CI 0.2-0.5) was associated with lower risk of infection-related cancer. Current CD4+ cell count less than 200 cells/μl was associated with both infection-related (adjHR 15.3, 95% CI 10.7-21.8) and noninfection-related cancer (adjHR 2.5, 95% CI 1.5-4.1), as was CD4+ cell count increases less than 100 cells/μl post antiretroviral therapy (ART) (infection-related cancer adjHR 6.6, 95% CI 4.2-10.6, noninfection-related cancer adjHR 2.0, 95% CI 1.2-3.3). CONCLUSION Current CD4+ cell count and failure to restore CD4+ cell count both associated with infection and noninfection-related cancer. Viral suppression associated with lower risk of infection-related cancer. Early HIV detection and early adherent ART remain essential for cancer prevention.
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Affiliation(s)
- Stina Malmström
- Department of Infectious Diseases, Västmanland County Hospital Västerås
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås
| | - Philippe Wagner
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås
| | - Aylin Yilmaz
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg
| | | | - Christina Carlander
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås
- Department of Medicine Huddinge
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Wong IKJ, Grulich AE, Poynten IM, Polizzotto MN, van Leeuwen MT, Amin J, McGregor S, Law M, Templeton DJ, Vajdic CM, Jin F. Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012. HIV Med 2022; 23:134-145. [PMID: 34585487 PMCID: PMC10499845 DOI: 10.1111/hiv.13179] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/10/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The aim of the study was to describe time trends in cancer incidence in people living with HIV (PLHIV) in Australia between 1982 and 2012. METHODS A population-based prospective study was conducted using data linkage between the national HIV and cancer registries. Invasive cancers identified in PLHIV were grouped into AIDS-defining cancers (ADCs), infection-related non-ADCs (NADCs), and non-infection-related NADCs. Crude and age-standardized incidence rates of cancers were calculated and compared over five time periods: 1982-1995, 1996-1999, 2000-2004, 2005-2008 and 2009-2012, roughly reflecting advances in HIV antiretroviral therapy. Standardized incidence ratios (SIRs) compared with the Australian general population were calculated for each time period. Generalized linear models were developed to assess time trends in crude and age-standardized incidences. RESULTS For ADCs, the crude and age-standardized incidences of Kaposi sarcoma and non-Hodgkin lymphoma substantially declined over time (P-trend < 0.001 for all) but SIRs remained significantly elevated. For infection-related NADCs, there were significant increases in the crude incidences of anal, liver and head and neck cancers. Age-standardized incidences increased for anal cancer (P-trend = 0.002) and liver cancer (P-trend < 0.001). SIRs were significantly elevated for anal cancer, liver cancer and Hodgkin lymphoma. For non-infection-related NADCs, the crude incidence of colorectal, lung and prostate cancers increased over time, but age-standardized incidences remained stable. CONCLUSIONS Continuous improvements and high coverage of antiretroviral therapy have reduced the incidence of ADCs in PLHIV in Australia. Clinical monitoring of anal and liver cancers in people living with HIV should be performed, given the increasing incidence of these cancers.
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Affiliation(s)
- Ian K J Wong
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | | | | | | | - Janaki Amin
- Department of Health Systems and Populations, Faculty of Medicine and Health Science, Macquarie University, Sydney, NSW, Australia
| | - Skye McGregor
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Matthew Law
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - David J Templeton
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
- Department of Sexual Health Medicine and Sexual Assault Medical Service, Sydney Local Health District, Camperdown, NSW, Australia
- Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Fengyi Jin
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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Micali C, Russotto Y, Caci G, Ceccarelli M, Marino A, Celesia BM, Pellicanò GF, Nunnari G, Venanzi Rullo E. Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV. Infect Dis Rep 2022; 14:43-55. [PMID: 35076514 PMCID: PMC8788283 DOI: 10.3390/idr14010006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) accounts for approximately 75-90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.
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Affiliation(s)
- Cristina Micali
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (Y.R.); (G.C.); (G.N.); (E.V.R.)
| | - Ylenia Russotto
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (Y.R.); (G.C.); (G.N.); (E.V.R.)
| | - Grazia Caci
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (Y.R.); (G.C.); (G.N.); (E.V.R.)
| | - Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (M.C.); (A.M.); (B.M.C.)
- Unit of Infectious Diseases, Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98124 Messina, Italy
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (M.C.); (A.M.); (B.M.C.)
| | - Benedetto Maurizio Celesia
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (M.C.); (A.M.); (B.M.C.)
| | - Giovanni Francesco Pellicanò
- Unit of Infectious Diseases, Department of Adult and Childhood Human Pathology “Gaetano Barresi”, University of Messina, 98124 Messina, Italy;
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (Y.R.); (G.C.); (G.N.); (E.V.R.)
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (Y.R.); (G.C.); (G.N.); (E.V.R.)
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Wong Y, Meehan MT, Burrows SR, Doolan DL, Miles JJ. Estimating the global burden of Epstein-Barr virus-related cancers. J Cancer Res Clin Oncol 2022; 148:31-46. [PMID: 34705104 PMCID: PMC8752571 DOI: 10.1007/s00432-021-03824-y] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/28/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND More than 90% of the adult population globally is chronically infected by the Epstein-Barr virus (EBV). It is well established that EBV is associated with a number of malignancies, and advances in knowledge of EBV-related malignancies are being made every year. Several studies have analysed the global epidemiology and geographic distribution of EBV-related cancers. However, most have only described a single cancer type or subtype in isolation or limited their study to the three or four most common EBV-related cancers. This review will present an overview on the spectrum of cancers linked to EBV based on observations of associations and proportions in the published literature while also using these observations to estimate the incidence and mortality burden of some of these cancers. METHOD We have reviewed the literature on defining features, distribution and outcomes across six cancers with a relatively large EBV-related case burden: Nasopharyngeal carcinoma (NPC), Gastric carcinoma (GC), Hodgkin lymphoma (HL), Burkitt lymphoma (BL), Diffuse large B-cell lymphoma (DLBCL) and Extranodal NK/T-cell lymphoma, Nasal type (ENKTL-NT). We retrieved published region-specific EBV-related case proportions for NPC, GC, HL and BL and performed meta-analyses on pooled region-specific studies of EBV-related case proportions for DLBCL and ENKTL-NT. We match these pooled proportions with their respective regional incidence and mortality numbers retrieved from a publicly available cancer database. Additionally, we also reviewed the literature on several other less common EBV-related cancers to summarize their key characteristics herein. CONCLUSION We estimated that EBV-related cases from these six cancers accounted for 239,700-357,900 new cases and 137,900-208,700 deaths in 2020. This review highlights the significant global impact of EBV-related cancers and extends the spectrum of disease that could benefit from an EBV-specific therapeutic.
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Affiliation(s)
- Yide Wong
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia.
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4870, Australia.
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, 4878, Australia.
| | - Michael T Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia
| | - Scott R Burrows
- QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia
| | - Denise L Doolan
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4870, Australia
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, 4878, Australia
| | - John J Miles
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4870, Australia
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, 4878, Australia
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Díaz-Álvarez J, Roiz P, Gorospe L, Ayala A, Pérez-Pinto S, Martínez-Sanz J, Sánchez-Conde M, Casado JL, Pérez-Elías MJ, Moreno A, Ron R, Vivancos MJ, Vizcarra P, Moreno S, Serrano-Villar S. Implementation of a lung cancer screening initiative in HIV-infected subjects. PLoS One 2021; 16:e0260069. [PMID: 34890391 PMCID: PMC8664191 DOI: 10.1371/journal.pone.0260069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 11/02/2021] [Indexed: 11/18/2022] Open
Abstract
In this pilot program of low-dose computed tomography (LDCT) for the screening of lung cancer (LC) in a targeted population of people with HIV (PWH), its prevalence was 3.6%; the number needed to screen in order to detect one case of lung cancer was 28, clearly outweighing the risks associated with lung cancer screening. While data from additional cohorts with longitudinal measurements are needed, PWH are a target population for lung cancer screening with LDCT.
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Affiliation(s)
- Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Patricia Roiz
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Department of Radiology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis Gorospe
- Department of Internal Medicine, Hospital de Ávila, Ávila, Spain
| | - Ana Ayala
- Department of Internal Medicine, Hospital de Ávila, Ávila, Spain
| | - Sergio Pérez-Pinto
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - José L. Casado
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - María J. Pérez-Elías
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Ana Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - María J. Vivancos
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Pilar Vizcarra
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Epidemiology of Kaposi's Sarcoma. Cancers (Basel) 2021; 13:cancers13225692. [PMID: 34830846 PMCID: PMC8616388 DOI: 10.3390/cancers13225692] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/24/2022] Open
Abstract
Kaposi's sarcoma is an angioproliferative tumor caused by human herpesvirus 8 in the context of immunodeficiency, such as that induced by HIV infection or immunosuppressive therapy. Its incidence has dramatically fallen in patients living with HIV (PLHIV) since the introduction of potent antiretroviral combinations 25 years ago due to the restoration of immunity and better control of HIV replication. However, KS is still one of the most frequently occurring cancers in PLHIV, in particular in men who have sex with men and in sub-Saharan Africa, where it is still endemic. Even in the context of restored immunity, the risk of KS is still more than 30 times higher in PLHIV than in the general population. Recent evidence indicates that early initiation of antiretroviral treatment, which is recommended by current guidelines, may reduce the risk of KS but it needs to be accompanied by early access to care. This review mainly focuses on the recent epidemiological features of KS in the context of HIV infection.
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Abstract
Kaposi sarcoma (KS) is a form of cancer that primarily appears on the skin but can potentially involve internal organs. There are several types of KS. The purpose of this article is to discuss the manifestations of KS and their appearance on imaging, the differential diagnoses associated with these findings, and molecular markers associated with KS that can aid appropriate diagnosis and therapy.
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Cheng Z, Lin P, Cheng N. HBV/HIV Coinfection: Impact on the Development and Clinical Treatment of Liver Diseases. Front Med (Lausanne) 2021; 8:713981. [PMID: 34676223 PMCID: PMC8524435 DOI: 10.3389/fmed.2021.713981] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a common contributor to chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Approximately 10% of people with human immunodeficiency virus (HIV) also have chronic HBV co-infection, owing to shared transmission routes. HIV/HBV coinfection accelerates the progression of chronic HBV to cirrhosis, end-stage liver disease, or hepatocellular carcinoma compared to chronic HBV mono-infection. HBV/HIV coinfection alters the natural history of hepatitis B and renders the antiviral treatment more complex. In this report, we conducted a critical review on the epidemiology, natural history, and pathogenesis of liver diseases related to HBV/HIV coinfection. We summarized the novel therapeutic options for these coinfected patients.
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Affiliation(s)
- Zhimeng Cheng
- Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Panpan Lin
- Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Nansheng Cheng
- Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu, China
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Kim HN, Newcomb CW, Carbonari DM, Roy JA, Torgersen J, Althoff KN, Kitahata MM, Reddy KR, Lim JK, Silverberg MJ, Mayor AM, Horberg MA, Cachay ER, Kirk GD, Sun J, Hull M, Gill MJ, Sterling TR, Kostman JR, Peters MG, Moore RD, Klein MB, Re VL, North American AIDS Cohort Collaboration on Research and Design of IeDEA. Risk of HCC With Hepatitis B Viremia Among HIV/HBV-Coinfected Persons in North America. Hepatology 2021; 74:1190-1202. [PMID: 33780007 PMCID: PMC8843101 DOI: 10.1002/hep.31839] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Chronic HBV is the predominant cause of HCC worldwide. Although HBV coinfection is common in HIV, the determinants of HCC in HIV/HBV coinfection are poorly characterized. We examined the predictors of HCC in a multicohort study of individuals coinfected with HIV/HBV. APPROACH AND RESULTS We included persons coinfected with HIV/HBV within 22 cohorts of the North American AIDS Cohort Collaboration on Research and Design (1995-2016). First occurrence of HCC was verified by medical record review and/or cancer registry. We used multivariable Cox regression to determine adjusted HRs (aHRs [95% CIs]) of factors assessed at cohort entry (age, sex, race, body mass index), ever during observation (heavy alcohol use, HCV), or time-updated (HIV RNA, CD4+ percentage, diabetes mellitus, HBV DNA). Among 8,354 individuals coinfected with HIV/HBV (median age, 43 years; 93% male; 52.4% non-White), 115 HCC cases were diagnosed over 65,392 person-years (incidence rate, 1.8 [95% CI, 1.5-2.1] events/1,000 person-years). Risk factors for HCC included age 40-49 years (aHR, 1.97 [1.22-3.17]), age ≥50 years (aHR, 2.55 [1.49-4.35]), HCV coinfection (aHR, 1.61 [1.07-2.40]), and heavy alcohol use (aHR, 1.52 [1.04-2.23]), while time-updated HIV RNA >500 copies/mL (aHR, 0.90 [0.56-1.43]) and time-updated CD4+ percentage <14% (aHR, 1.03 [0.56-1.90]) were not. The risk of HCC was increased with time-updated HBV DNA >200 IU/mL (aHR, 2.22 [1.42-3.47]) and was higher with each 1.0 log10 IU/mL increase in time-updated HBV DNA (aHR, 1.18 [1.05-1.34]). HBV suppression with HBV-active antiretroviral therapy (ART) for ≥1 year significantly reduced HCC risk (aHR, 0.42 [0.24-0.73]). CONCLUSION Individuals coinfected with HIV/HBV on ART with detectable HBV viremia remain at risk for HCC. To gain maximal benefit from ART for HCC prevention, sustained HBV suppression is necessary.
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Affiliation(s)
| | | | | | - Jason A. Roy
- Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA
| | | | | | | | | | | | | | - Angel M. Mayor
- Retrovirus Research Center, Universidad Central del Caribe, Bayamon, Puerto Rico
| | | | | | | | - Jing Sun
- Johns Hopkins University, Baltimore, MD, USA
| | - Mark Hull
- University of British Columbia, Vancouver, Canada
| | | | | | - Jay R. Kostman
- Philadelphia Field Initiating Group for HIV Trials, Philadelphia, PA, USA
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Hodgkin Lymphoma in People Living with HIV. Cancers (Basel) 2021; 13:cancers13174366. [PMID: 34503176 PMCID: PMC8430611 DOI: 10.3390/cancers13174366] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 01/24/2023] Open
Abstract
Simple Summary Hodgkin lymphoma (HL) is a non-AIDS defining neoplasm, but people living with HIV (PLWH) have between a 5- and 26-fold higher risk of developing it than the general population. Epstein-Barr virus is present in almost all HIV-related HL cases, and plays an important role in its etiopathogenesis. Despite the aggressive characteristics, the prognosis of HL affecting PLWH is similar to that of the general population if patients are treated following the same recommendations. Administration of cART concomitantly with chemotherapy is highly recommended. However, this combination may be challenging due to drug–drug interactions and overlapping toxicity. Thus, interdisciplinary collaboration between hemato-oncologists and HIV specialists is crucial for the optimal treatment of both lymphoma and HIV infection. Abstract Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein–Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug–drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it.
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Dzobo K. What to Do for Increasing Cancer Burden on the African Continent? Accelerating Public Health Diagnostics Innovation for Prevention and Early Intervention on Cancers. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:567-579. [PMID: 34399067 DOI: 10.1089/omi.2021.0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
No other place illustrates the increasing burden of cancer than in Africa and in particular, sub-Saharan Africa. Many of the individuals to be diagnosed with cancer will be in low-resource settings in the future due to, for example, an increase in populations and aging, and high co-morbidity with infections with viruses such as human immunodeficiency virus (HIV) and human papillomavirus (HPV), as well as the presence of infectious agents linked to cancer development. Due to lack of prevention and diagnostic innovation, patients present with advanced cancers, leading to poor survival and increased mortality. HIV infection-associated cancers such as B cell lymphomas, Kaposi's sarcoma, and HPV-associated cancers such as cervical cancer are particularly noteworthy in this context. Recent reports show that a host of other cancers are also associated with viral infection and these include lung, oral cavity, esophageal, and pharyngeal, hepatocellular carcinoma, and anal and vulvar cancers. This article examines the ways in which diagnostic innovation empowered by integrative biology and informed by public health priorities can improve cancer prevention or early intervention in Africa and beyond. In addition, I argue that because diagnostic biomarkers can often overlap with novel therapeutic targets, diagnostics research and development can have broader value for and impact on medical innovation.
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Affiliation(s)
- Kevin Dzobo
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine, Division of Medical Biochemistry, Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Martínez LE, Lensing S, Chang D, Magpantay LI, Mitsuyasu R, Ambinder RF, Sparano JA, Martínez-Maza O, Epeldegui M. Immune Activation and Microbial Translocation as Prognostic Biomarkers for AIDS-Related Non-Hodgkin Lymphoma in the AMC-034 Study. Clin Cancer Res 2021; 27:4642-4651. [PMID: 34131000 PMCID: PMC8364886 DOI: 10.1158/1078-0432.ccr-20-4167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/30/2021] [Accepted: 06/09/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE AIDS-related non-Hodgkin lymphoma (ARL) is the most common cancer in HIV-infected individuals in the United States and other countries in which HIV-positive persons have access to effective combination antiretroviral therapy (cART). Our prior work showed that pretreatment/postdiagnosis plasma levels of some cytokines, such as IL6, IL10, and CXCL13, have the potential to serve as indicators of clinical response to treatment and survival in ARL. The aims of this study were to identify novel prognostic biomarkers for response to treatment and/or survival in persons with ARL, including biomarkers of microbial translocation and inflammation. EXPERIMENTAL DESIGN We quantified plasma levels of several biomarkers (sCD14, LBP, FABP2, EndoCab IgM, IL18, CCL2/MCP-1, sCD163, IP-10/CXCL10, TARC/CCL17, TNFα, BAFF/BLyS, sTNFRII, sCD44, and sIL2Rα/sCD25) by multiplexed immunometric assays (Luminex) or ELISA in plasma specimens obtained from ARL patients enrolled in the AMC-034 trial, which compared infusional combination chemotherapy (EPOCH: etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone) with concurrent or sequential rituximab. Plasma was collected prior to the initiation of therapy (n = 57) and after treatment initiation (n = 55). RESULTS We found that several biomarkers decreased significantly after treatment, including TNFα, sCD25, LBP, and TARC (CCL17). Moreover, pretreatment plasma levels of BAFF, sCD14, sTNFRII, and CCL2/MCP-1 were univariately associated with overall survival, and pretreatment levels of BAFF, sTNFRII, and CCL2/MCP-1 were also associated with progression-free survival. CONCLUSIONS Our results suggest that patients with ARL who responded to therapy had lower pretreatment levels of inflammation and microbial translocation as compared with those who did not respond optimally.
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Affiliation(s)
- Laura E Martínez
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, California
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Shelly Lensing
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Di Chang
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Larry I Magpantay
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, California
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ronald Mitsuyasu
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, California
| | - Richard F Ambinder
- Division of Hematologic Malignancies, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Joseph A Sparano
- Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Otoniel Martínez-Maza
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, California
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California
| | - Marta Epeldegui
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, California.
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California
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Al Bitar S, Ballouz T, Doughan S, Gali-Muhtasib H, Rizk N. Potential role of micro ribonucleic acids in screening for anal cancer in human papilloma virus and human immunodeficiency virus related malignancies. World J Gastrointest Pathophysiol 2021; 12:59-83. [PMID: 34354849 PMCID: PMC8316837 DOI: 10.4291/wjgp.v12.i4.59] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/24/2021] [Accepted: 05/19/2021] [Indexed: 02/06/2023] Open
Abstract
Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) continues to be a major global public health issue owing to the increased mortality rates related to the prevalent oncogenic viruses among people living with HIV (PLWH). Human papillomavirus (HPV) is the most common sexually transmitted viral disease in both men and women worldwide. High-risk or oncogenic HPV types are associated with the development of HPV-related malignancies, including cervical, penile, and anal cancer, in addition to oral cancers. The incidence of anal squamous cell cancers is increasing among PLWH, necessitating the need for reliable screening methods in this population at risk. In fact, the currently used screening methods, including the Pap smear, are invasive and are neither sensitive nor specific. Investigators are interested in circulatory and tissue micro ribonucleic acids (miRNAs), as these small non-coding RNAs are ideal biomarkers for early detection and prognosis of cancer. Multiple miRNAs are deregulated during HIV and HPV infection and their deregulation contributes to the pathogenesis of disease. Here, we will review the molecular basis of HIV and HPV co-infections and focus on the pathogenesis and epidemiology of anal cancer in PLWH. The limitations of screening for anal cancer and the need for a reliable screening program that involves specific miRNAs with diagnostic and therapeutic values is also discussed.
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Affiliation(s)
- Samar Al Bitar
- Department of Biology, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Tala Ballouz
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Samer Doughan
- Department of Surgery, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Hala Gali-Muhtasib
- Department of Biology and Center for Drug Discovery, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Nesrine Rizk
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
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Sheykhhasan M, Foroutan A, Manoochehri H, Khoei SG, Poondla N, Saidijam M. Could gene therapy cure HIV? Life Sci 2021; 277:119451. [PMID: 33811896 DOI: 10.1016/j.lfs.2021.119451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/12/2021] [Accepted: 03/27/2021] [Indexed: 02/05/2023]
Abstract
The Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) continues to be a major global public health issue, having claimed almost 33 million lives so far. According to the recent report of the World Health Organization (WHO) in 2019, about 38 million people are living with AIDS. Hence, finding a solution to overcome this life-threatening virus can save millions of lives. Scientists and medical doctors have prescribed HIV patients with specific drugs for many years. Methods such antiretroviral therapy (ART) or latency-reversing agents (LRAs) have been used for a while to treat HIV patients, however they have some side effects and drawbacks causing their application to be not quite successful. Instead, the application of gene therapy which refers to the utilization of the therapeutic delivery of nucleic acids into a patient's cells as a drug to treat disease has shown promising results to control HIV infection. Therefore, in this review, we will summarize recent advances in gene therapy approach against HIV.
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Affiliation(s)
- Mohsen Sheykhhasan
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Aidin Foroutan
- Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada; Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Hamed Manoochehri
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeideh Gholamzadeh Khoei
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Naresh Poondla
- Richmond University Medical center, 355, Bard Avenue, Staten Island, New York 10310, United States
| | - Massoud Saidijam
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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Sun S, Xu B, Zhang Q, Zhao CS, Ma R, He J, Zhang Y. The Early Results of Vertebral Pathological Compression Fracture of Extra- nodal Lymphoma with HIV-positive Patients Treated by Percutaneous Kyphoplasty. Curr HIV Res 2021; 18:248-257. [PMID: 32386494 DOI: 10.2174/1570162x18666200510010207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/14/2020] [Accepted: 04/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Vertebral pathological compression fracture involving extra-nodal lymphoma impacts negatively on the quality of life of HIV-positive patients. The choice of a safe and effective approach to palliative care in this condition remains a challenge. OBJECTIVE The purpose of this study was to investigate the safety and efficacy of percutaneous kyphoplasty (PKP) in the treatment of vertebral pathological compression fracture of extra-nodal lymphoma in HIV-positive patients. METHODS A retrospective analysis, from January 2016 to August 2019, was performed on 7 HIVpositive patients, 3 males and 4 females, with extra-nodal lymphoma with a vertebral pathological compression fracture. The patients were treated using percutaneous kyphoplasty in our hospital. Preoperative assessment of the patients was conducted regarding their hematological profile, biochemical indicators, liver and kidney function, blood coagulation function, CD4+T lymphocyte count and viral load. Subsequently, the patients were placed on highly active antiretroviral therapy (HAART) and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) regimen. Besides, antibiotics, nutritional support and immune-modulating drugs were also administered, rationally. Postoperatively, the height of the anterior edge of the injured vertebrae, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) values were evaluated. Patients were also monitored for any complications related to the operation. RESULTS The average CD4+T cell count for the patients was 164 (range 114 ~247 / ul), while the viral load was 26,269 (range 5,765 ~82,321 copies/ul). All patients received nutritional and immune support and registered significant improvements in the levels of ALB and Hb (P<0.05). In all cases, the operation was uneventful with neither cement leakage nor toxic reactions observed. Similarly, no opportunistic infections, other complications or deaths were reported. The height of the anterior vertebral body and the ODI score of the injured vertebrae were significantly improved immediately after surgery (P<0.05). Compared to the preoperative VAS (7.71±1.11), postoperative values were significantly reduced immediately after surgery (3.85±0.90) and at 2 weeks, 1 month and 6 months post-surgery: 2.71±0.76, 3.29±1.11, and 4.00±0.82, respectively (P<0.01). CONCLUSION Supported with appropriate perioperative treatment measures, PKP is safe and effective in the treatment of pathological vertebral compression fracture due to extra-nodal lymphoma in HIV-positive patients.
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Affiliation(s)
- Sheng Sun
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Biao Xu
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Qiang Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Chang-Song Zhao
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Rui Ma
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Jie He
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
| | - Yao Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No.8, Jingshun East Street, Chaoyang District, Beijing 100015, China
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Puerta-Alcalde P, Ambrosioni J, Chumbita M, Hernández-Meneses M, Garcia-Pouton N, Cardozo C, Moreno-García E, Marco F, Mensa J, Rovira M, Esteve J, Martínez JA, García F, Mallolas J, Soriano A, Miró JM, Garcia-Vidal C. Clinical Characteristics and Outcome of Bloodstream Infections in HIV-Infected Patients with Cancer and Febrile Neutropenia: A Case-Control Study. Infect Dis Ther 2021; 10:955-970. [PMID: 33840061 PMCID: PMC8116456 DOI: 10.1007/s40121-021-00445-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/27/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION We aimed to compare the clinical characteristics and outcomes of bloodstream infections (BSI) in cancer patients presenting febrile neutropenia with and without HIV infection, and analyze the prognostic factors for mortality. METHODS BSI episodes in febrile neutropenic patients following chemotherapy were prospectively collected (1997-2018). A case (HIV-infected)-control (non-HIV-infected) sub-analysis was performed (1:2 ratio), matching patients by age, gender, baseline disease, and etiological microorganism. RESULTS From 1755 BSI episodes in neutropenic cancer patients, 60 (3.4%) occurred in those with HIV. HIV characteristics: 51.7% were men who have sex with men; 58.3% had < 200 CD4; 51.7% had a detectable HIV-1 RNA viral load before the BSI episode; 70.0% met AIDS-defining criteria; and 93.3% were on antiretroviral therapy, with a protease inhibitor-based regimen being the most common (53.0%). HIV-infected patients were younger, more frequently male and more commonly presenting chronic liver disease (p < 0.001 for all). BSI due to Enterococcus spp. was significantly more frequent among patients with HIV (p = 0.017) with no differences in other pathogens. HIV-infected patients with cancer presented with shock more frequently (p = 0.014) and had higher mortality (31.7% vs. 18.1%, p = 0.008). In the case-control analysis, cases (HIV-infected) had chronic liver disease (p = 0.003) more frequently, whereas acute leukemia (p = 0.013) and hematopoietic stem-cell transplant (p = 0.023) were more common among controls. There was a non-significant trend for cases to have higher mortality (p = 0.084). However, in multivariate analysis, HIV infection was not associated with mortality (p = 0.196). CONCLUSION HIV-infected patients with cancer developing febrile neutropenia and BSI have different epidemiological and clinical profiles, and experience higher mortality. However, HIV infection by itself was not associated with mortality.
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Affiliation(s)
- Pedro Puerta-Alcalde
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain.
| | - Juan Ambrosioni
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain.
| | - Mariana Chumbita
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Marta Hernández-Meneses
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Nicole Garcia-Pouton
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Celia Cardozo
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Estela Moreno-García
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Francesc Marco
- Microbiology Department, Centre Diagnòstic Biomèdic, Hospital Clinic, Barcelona, Spain
- ISGlobal, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josep Mensa
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
| | - Montserrat Rovira
- Hematology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Hematology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Jose A Martínez
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Felipe García
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Josep Mallolas
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Alex Soriano
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - José M Miró
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Infectious Diseases Department, Hospital Clinic-IDIBAPS, Carrer de Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
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Strickler HD, Keller MJ, Hessol NA, Eltoum IE, Einstein MH, Castle PE, Massad LS, Flowers L, Rahangdale L, Atrio JM, Ramirez C, Minkoff H, Adimora AA, Ofotokun I, Colie C, Huchko MJ, Fischl M, Wright R, D’Souza G, Leider J, Diaz O, Sanchez-Keeland L, Shrestha S, Xie X, Xue X, Anastos K, Palefsky JM, Burk RD. Primary HPV and Molecular Cervical Cancer Screening in US Women Living With Human Immunodeficiency Virus. Clin Infect Dis 2021; 72:1529-1537. [PMID: 32881999 PMCID: PMC8096228 DOI: 10.1093/cid/ciaa1317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Primary human papillomavirus (HPV) screening (PHS) utilizes oncogenic human papillomavirus (oncHPV) testing as the initial cervical cancer screening method and typically, if positive, additional reflex-triage (eg, HPV16/18-genotyping, Pap testing). While US guidelines support PHS usage in the general population, PHS has been little studied in women living with HIV (WLWH). METHODS We enrolled n = 865 WLWH (323 from the Women's Interagency HIV Study [WIHS] and 542 from WIHS-affiliated colposcopy clinics). All participants underwent Pap and oncHPV testing, including HPV16/18-genotyping. WIHS WLWH who tested oncHPV[+] or had cytologic atypical squamous cells of undetermined significance or worse (ASC-US+) underwent colposcopy, as did a random 21% of WLWH who were oncHPV[-]/Pap[-] (controls). Most participants additionally underwent p16/Ki-67 immunocytochemistry. RESULTS Mean age was 46 years, median CD4 was 592 cells/µL, 95% used antiretroviral therapy. Seventy WLWH had histologically-determined cervical intraepithelial neoplasia grade 2 or greater (CIN-2+), of which 33 were defined as precancer (ie, [i] CIN-3+ or [ii] CIN-2 if concurrent with cytologic high grade squamous intraepithelial lesions [HSILs]). PHS had 87% sensitivity (Se) for precancer, 9% positive predictive value (PPV), and a 35% colposcopy referral rate (Colpo). "PHS with reflex HPV16/18-genotyping and Pap testing" had 84% Se, 16% PPV, 30% Colpo. PHS with only HPV16/18-genotyping had 24% Colpo. "Concurrent oncHPV and Pap Testing" (Co-Testing) had 91% Se, 12% PPV, 40% Colpo. p16/Ki-67 immunochemistry had the highest PPV, 20%, but 13% specimen inadequacy. CONCLUSIONS PHS with reflex HPV16/18-genotyping had fewer unnecessary colposcopies and (if confirmed) could be a potential alternative to Co-Testing in WLWH.
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Affiliation(s)
- Howard D Strickler
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Marla J Keller
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Nancy A Hessol
- University of California, San Francisco, California, USA
| | | | | | - Philip E Castle
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | | | - Lisa Flowers
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lisa Rahangdale
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessica M Atrio
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Catalina Ramirez
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Adaora A Adimora
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Igho Ofotokun
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christine Colie
- Georgetown University, Washington, District of Columbia, USA
| | - Megan J Huchko
- University of California, San Francisco, California, USA
| | - Margaret Fischl
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rodney Wright
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Gypsyamber D’Souza
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Olga Diaz
- Jacobi Medical Center, Bronx, New York, USA
| | | | | | - Xianhong Xie
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Xiaonan Xue
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Kathryn Anastos
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | | | - Robert D Burk
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
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Coburn SB, Shiels MS, Silverberg MJ, Horberg MA, Gill MJ, Brown TT, Visvanathan K, Connor AE, Napravnik S, Marcus JL, Moore RD, Mathews WC, Mayor AM, Sterling TR, Li J, Rabkin CS, D’Souza G, Lau B, Althoff KN. Secular Trends in Breast Cancer Risk Among Women With HIV Initiating ART in North America. J Acquir Immune Defic Syndr 2021; 87:663-670. [PMID: 33492023 PMCID: PMC8026587 DOI: 10.1097/qai.0000000000002627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studies suggest lower risk of breast cancer in women with HIV versus without HIV. These estimates may be biased by lower life expectancy and younger age distribution of women with HIV. Our analysis evaluated this bias and characterized secular trends in breast cancer among women with HIV initiating antiretroviral therapy. We hypothesized breast cancer risk would increase over time as mortality decreased. SETTING Women with HIV prescribed antiretroviral therapy in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) from 1997 through 2016. METHODS We estimated breast cancer hazard (cause-specific hazard ratios) and cumulative incidence accounting for competing risks (subdistribution hazard ratios) to assess changes in breast cancer risk over time. This was assessed overall (1997-2016) and within/across calendar periods. Analyses were adjusted for race/ethnicity and inverse probability weighted for cohort. Cumulative incidence was graphically assessed by calendar period and race/ethnicity. RESULTS We observed 11,587 women during 1997-2016, contributing 63 incident breast cancer diagnoses and 1,353 deaths [73,445 person-years (median follow-up = 4.5 years)]. Breast cancer cumulative incidence was 3.2% for 1997-2016. We observed no secular trends in breast cancer hazard or cumulative incidence. There were annual declines in the hazard and cumulative incidence of death (cause-specific hazard ratios and subdistribution hazard ratios: 0.89, 95% confidence interval: 0.87 to 0.91) which remained within and across calendar periods. CONCLUSIONS These findings contradict the hypothesis of increasing breast cancer risk with declining mortality over time among women with HIV, suggesting limited impact of changing mortality on breast cancer risk. Additional inquiry is merited as survival improves among women with HIV.
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Affiliation(s)
- Sally B. Coburn
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, Infections
and Immunoepidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland,
USA
| | - Michael J. Silverberg
- Division of Research, Kaiser Permanente Northern
California, Oakland, California, USA
| | - Michael A. Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser
Permanente Mid-Atlantic States, Rockville, Maryland, USA
| | - M. John Gill
- Department of Medicine, University of Calgary, Calgary,
Alberta, Canada
| | - Todd T. Brown
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Avonne E. Connor
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julia L. Marcus
- Department of Population Medicine, Harvard University,
Cambridge, Massachusetts, USA
| | - Richard D. Moore
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - W. Chris Mathews
- Department of Medicine, University of California San Diego,
San Diego, California, USA
| | - Angel Mauricio Mayor
- Department of Medicine, Universidad Central del Caribe,
Bayamón, Puerto Rico, USA
| | - Timothy R. Sterling
- Department of Medicine, Division of Infectious Diseases,
Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jun Li
- Division of HIV/AIDS Prevention, National Center for
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
| | - Charles S. Rabkin
- Division of Cancer Epidemiology and Genetics, Infections
and Immunoepidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland,
USA
| | - Gyspyamber D’Souza
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins University,
Baltimore, Maryland, USA
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