HIV Infection and Non-AIDS-Defining Malignancies: An Outpatient Clinic Experience

Abstract

Introduction: Human Immunodeficiency Virus infected patients have an increased risk for developing different types of cancer. After the introduction of highly active antiretroviral therapy (HAART), and consequent increased survival, a shift has been seen in the spectrum and evolution of HIV infection related diseases, particularly oncological ones, with a tendency to increase non-AIDS-defining malignancies (NADM) as opposed to AIDS defining malignancies.
Material and Methods: Characterization of the Human Immunodeficiency Virus infected patients with a non-AIDS defining malignancy diagnosis, followed over 16 years at an outpatient clinic in Lisbon through the review of medical records and retrospective evaluation of demographic, epidemiological, clinical and laboratorial parameters, treatment and mortality.
Results: Of the 1042 patients evaluated, there were 34 Non- AIDS defining malignancy cases identified, mostly in men (78%), with a median age of 55 years. The most common cancers were: lung (20.6%), bladder (17.6%), prostate (8.8%), and anal carcinoma (5.9%). The mean time between Human Immunodeficiency Virus infection and non-AIDS-defining malignancy diagnosis was 6.8 ± 4 years. At the time of non-AIDS- defining malignancy diagnosis the majority of patients (78.8%) was receiving HAART for a mean period of 5.7 ± 3 years, most of whom were immune and virologically controlled (64%). There were 45.5% deaths, mainly in patients with lung cancer (20%).
Conclusion: Given the risk of developing a non-AIDS-defining malignancy in Human Immunodeficiency Virus-infected patients, it is essential to continue to invest in prevention strategies, promote smoking cessation as well as vaccination programs, as well as applying screening protocols adjusted to this population.