The Spectrum of Malignancies among Adult HIV Cohort in Poland between 1995 and 2012: A Retrospective Analysis of 288 Cases

The aim of the study was to evaluate the spectrum of AIDS-defining malignancies (ADMs) and non-AIDS-defining malignancies (NADMs) in HIV-infected patients in Poland.

A retrospective observational study was conducted among HIV-infected adult patients who developed a malignancy between 1995 and 2012 in a Polish cohort. Malignancies were divided into ADMs and NADMs. Non-AIDS-defining malignancies were further categorised as virus-related (NADMs-VR) and unrelated (NADMs-VUR). Epidemiological data was analysed according to demographic data, medical history, and HIV-related information. Results were analysed by OR, EPITools package parameters and Fisher's exact test.

Results: In this study 288 malignancies were discovered. The mean age at diagnosis was 41.25 years (IQR20-81); for ADMs 38.05 years, and for NADMs-VURs 46.42 years; 72.22% were male, 40.28% were co-infected with HCV. The risk behaviours were: 37.85% IDU, 33.33% MSM, and 24.31% heterosexual. Mean CD4+ at the diagnosis was 282 cells/mm³ (for ADMs 232 and for NADMs-VUR 395). Average duration of HIV infection at diagnosis was 5.69 years. There were 159 (55.2%) ADMs and 129 (44.8%) NADMs, among whom 58 (44.96%) NADMs-VR and 71 (55.04%) NADMs-VUR. 

The most frequent malignancies were: NHL (26.39%), KS (17.01%), ICC (11.81%), HD (7.99%), lung cancer (6.25%) and HCC (4.86%). The amount of NADMs, NADMs-VURs in particular, is increasing at present. Male gender, advanced age: 50–60 years and ≥ 60 years, longer duration of HIV-infection and successful HAART were independent predictors of NADMs overall, respectively.

Conclusions

In a Polish cohort NHL was the most frequent malignancy among ADMs, whereas HD was the most frequent among NADMs. Increased incidence of NADMs appearing in elderly men with longer duration of HIV-infection and with better virological and immunological control was confirmed. As HIV-infected individuals live longer, better screening strategies, especially for NADMs-VUR, are needed. The spectrum of cancer diagnoses in Poland currently does not appear dissimilar to that observed in other European populations.

Below:  Estimated prevalence of AIDS-defining malignancies (ADMs) and non-AIDS-defining malignancies (NADMs). The latter are divided into virus related (NADMs-VR) and virus unrelated (NADMs-VUR) over the presented periods of time

Full article at: http://goo.gl/unAlxb

By:  Jacek Kowalski,1 Grażyna Cholewińska,1 Karolina Pyziak-Kowalska,1 Elżbieta Jabłonowska,2 Grażyna Barałkiewicz,3Anna Grzeszczuk,4 Magdalena Leszczyszyn-Pynka,5 Anita Olczak,6 Maria Jankowska,7 Tomasz Mikuła,8 Monika Bociąga-Jasik,9 Ewa Firląg-Burkacka,8 and Andrzej Horban8

¹Hospital for Infectious Diseases in Warsaw, Warsaw, Poland

²University of Lodz, Lodz, Poland

³Poznan University of Medical Sciences, Poznan, Poland

⁴Medical University of Bialystok, Bialystok, Poland

⁵Pomeranian Medical University, Szczecin, Poland

⁶Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland

⁷Medical University of Gdansk, Gdansk, Poland

⁸Medical University of Warsaw, Warsaw, Poland

⁹Jagiellonian University Medical College, Krakow, Poland

Corresponding author.

Address for correspondence: Jacek Kowalski, Hospital for Infectious Diseases in Warsaw, Wolska 37, 01-201 Warsaw, Poland. e-mail:moc.liamg@2891ikslawokkecaj

 

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