Cancer in HIV-infected persons from the Caribbean, Central and South America

J Acquir Immune Defic Syndr. 2011 Apr 15;56(5):467-73. doi: 10.1097/QAI.0b013e31820bb1c3.


Background: HIV-infected individuals have heightened cancer risk. With the advent of highly active antiretroviral therapy (HAART), the frequency of some AIDS-defining cancers (ADC) has decreased although certain non-AIDS-defining cancers (NADC) are becoming more frequent. Cancers among HIV-infected individuals in Latin American and the Caribbean have not yet been carefully studied.

Methods: Cancer cases among the Caribbean, Central and South American network for HIV Research (CCASAnet) cohort were identified reviewing clinical records and pre-existing databases.

Results: There were 406 cancers reported: 331 ADC (224 Kaposi sarcomas and 98 non Hodgkin lymphomas). Most frequent NADC (n = 75) were Hodgkin lymphoma and skin cancers. Seventy-three percent of NADC and 45% of ADC were diagnosed >1 year after HIV diagnosis. Fifty-six percent of ADC occurred before HAART start. Median time from HAART start until cancer diagnosis was 2.5 years for NADC and 0.5 years for ADC (P = <0.001). Within 3372 HAART starters, 158 were diagnosed with 165 cancers (82.4% ADC); 85 cases were previous to or concomitant with HAART initiation. Incidence of cancer after HAART initiation in 8080 person-years of follow-up was 7.2 per 1000 person-years (95% confidence interval = 5.5 to 9.3) for ADC and 2.7 (95% confidence interval = 1.8 to 4.1) for NADC; incidence was higher in the first 2 months, particularly for ADC (47.6). A pre-HAART ADC was a predictor of mortality after adjusting for age, sex, and CD4 at HAART initiation.

Conclusions: ADC were the most frequent cancers in this region and were often diagnosed close to HIV diagnosis and HAART start. Incidence of cancer was highest around HAART initiation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • Caribbean Region / epidemiology
  • Central America / epidemiology
  • Cohort Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Hodgkin Disease / complications
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / epidemiology
  • Humans
  • Incidence
  • Lymphoma, AIDS-Related / complications
  • Lymphoma, AIDS-Related / diagnosis
  • Lymphoma, AIDS-Related / epidemiology*
  • Male
  • Middle Aged
  • Neoplasms / classification
  • Neoplasms / complications*
  • Neoplasms / epidemiology*
  • Sarcoma, Kaposi / complications
  • Sarcoma, Kaposi / diagnosis
  • Sarcoma, Kaposi / epidemiology*
  • South America / epidemiology