Neoplasia in patients with HIV infection: effect of HAART

Abstract number: 1733_152

Garcia-Egido A.A., Escobar M.A., Romero S.P., Bernal J.A., Asencio C., Puerto J.L., Gonzalez-Outon J., Gomez F.

Surveillance data indicate that, the incidence and type of HIV related neoplasias has changed after the introduction of HAART.

Objective: To determine the incidence and types of cancers in the pre-HAART and post-HAART eras, and the differences between women and men.

Methods: Retrospective record review of HIV infected patients with cancer from January 1991 to December 2003 at a teaching hospital.

Results: A total of 215 HIV patients with cancer were identified, 173 men (age: 38±11 years, CD4: 123±39/mL) and 42 women (age: 44±16 years, CD4: 68±27/mL), of them 90 were detected in the pre-HAART (47%) and 102 in the post-HAART era (53%, p = n/s). AIDS defining cancers (Total: 215, 72.4%; of them 108, 77.7% in men vs. 31, 22.3% in women) were more frequent pre-HAART (Total: 76, 54.7%; of them 60, 43% in men vs. 16, 11.5% in women) than post-HAART (Total: 63, 45.3%; of them 48, 34.5% in men vs. 15, 10.8% in women). Non AIDS defining cancers (Total: 53, 27.6%; of them 34, 64% in men vs. 19, 36% in women) were less frequent pre-HAART (Total: 14, 26.4%; of them 9, 17% in men vs. 5, 5.3% in women) than post-HAART (Total: 39, 73.6%; of them 25, 47.2% in men vs. 14, 26.4% in women). Total cancer related mortality was higher pre-HAART (61% vs 52%, p < 0.05) and in women (60% vs 55%, p = n/s) than post-HAART (Total: 53, 27.6%; of them 36, 18.8% in men vs. 17, 8.9% in women). AIDS defining cancer related mortality was higher pre-HAART (65.8% vs 36.5%, p < 0.01) in both sexes (p < 0.01), while non AIDS defining cancer related mortality was higher post-HAART (76.9% vs 35.7%, p < 0.01) in both sexes (p < 0.01).

Conclusions: The incidence of non AIDS defining cancer increased, although the total incidence of HIV related neoplasia has not changed after HAART. Total cancer related mortality is higher pre-HAART and in women. Both sexes have a higher mortality by AIDS defining cancer pre-HAART and, by non AIDS defining cancer post-HAART.