Seroprevalence of human immunodeficiency virus type 1 infection in childhood malignancy in Zimbabwe.

OBJECTIVES

To determine the association between malignancy and the Human Immunodeficiency Virus type 1 (HIV-1) infection in children.

DESIGN

Case series.

SETTING

The Paediatric Oncology Unit at Parirenyatwa Teaching Hospital.

SUBJECTS

76 consecutive newly diagnosed cases of malignancy between May 15 and November 15 1997.

MAIN OUTCOME MEASURES

HIV serostatus.

RESULTS

27 out of 64 children were HIV seropositive, giving a seroprevalance rate of 42.2% (95% CI 30.1 to 54.3%). The four commonest diagnosed malignancies were non-Hodgkin's lymphoma (22.4%), acute lymphoblastic leukemia (19.7%), Wilm's tumour (19.7%) and Kaposi's sarcoma (15.8%). These tumours accounted for 77.6% of all malignancies. Nine of a total of 17 patients with non-Hodgkin's lymphoma were HIV positive and all 12 patients with Kaposi's were also HIV positive. No cases of Burkitt's lymphoma were seen. Although there was increased incidence of non-Hodgkin's lymphoma (NHL) compared to previous years, there was no significant association with the HIV serostatus. A significant association between Kaposi's sarcoma (KS) and HIV serostatus was observed (p < 0.001). Children with KS were more likely to be HIV seropositive. Children with acute lymphoblastic leukemia (ALL) and Wilm's tumours (WT) were 83 and 88% less likely to be HIV seropositive, respectively.

CONCLUSIONS

HIV has transformed the pattern of childhood malignancy in Zimbabwe. The two tumours mostly affected are NHL and KS.