Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Cancer Treat Res Commun. 2020;25:100213. doi: 10.1016/j.ctarc.2020.100213. Epub 2020 Sep 29.
Although the burden of human immunodeficiency virus (HIV) infection in Tanzania is high, limited data are available on cancers in HIV-infected patients. We aimed to determine the spectrum and prevalence of cancers in HIV-infected patients attending care at a zonal hospital in Tanzania.
Clinical records of HIV-infected patients from 2009 to 2019 were identified and retrospectively reviewed.
A total of 3398 HIV-infected patients were recruited with median age of 37 years. Cancer was diagnosed in 9% of the patients after enrollment into HIV clinical care, with an increasing prevalence from 7.2% between years 2009 and 2013 to 8.6% between years 2017 and 2019 (p-value <0.0001). Majority (89.2%) were on antiretroviral therapy (ART) during the time of cancer diagnosis. The proportions of acquired immunodeficiency syndrome (AIDS)-defining cancers and non-AIDS defining cancers were 28% and 72% respectively. Kaposi's sarcoma was the most common (13.2%) AIDS-defining cancer while esophageal cancer was the most common (11.1%) non-AIDS defining cancer. The median duration of time from HIV infection to cancer diagnosis was 715 days (IQR: 98-2570). The median CD4T-cell count was 318(IQR 159-690) cells/µl at the time of cancer diagnosis and 40.7% of the patients had advanced immunosuppression with CD4 count less than 200 cells/µl at the time of cancer diagnosis.
Non-AIDS defining cancers were much more common than AIDS-defining cancers suggesting increased longevity due to ART access. The prevalence of cancer among HIV-infected patients was 9% with an increasing trend over time; highlighting the importance of promoting cancer screening in this vulnerable population and implementation of vaccinations programs for liver and cervical cancers as well as tobacco control policies for smoking-related cancers.
尽管坦桑尼亚的人类免疫缺陷病毒（HIV）感染负担很高，但有关 HIV 感染患者癌症的数据有限。我们旨在确定在坦桑尼亚一家区域医院接受治疗的 HIV 感染患者的癌症谱和患病率。
从 2009 年至 2019 年，确定了 HIV 感染患者的临床记录，并进行了回顾性审查。
共招募了 3398 名 HIV 感染患者，中位年龄为 37 岁。在纳入 HIV 临床护理后，9%的患者被诊断患有癌症，患病率从 2009 年至 2013 年的 7.2%增加到 2017 年至 2019 年的 8.6%（p 值<0.0001）。在癌症诊断时，大多数（89.2%）患者正在接受抗逆转录病毒治疗（ART）。获得性免疫缺陷综合征（AIDS）定义的癌症和非 AIDS 定义的癌症的比例分别为 28%和 72%。卡波西肉瘤是最常见的（13.2%） AIDS 定义的癌症，而食管癌是最常见的（11.1%）非 AIDS 定义的癌症。从 HIV 感染到癌症诊断的中位时间为 715 天（IQR：98-2570）。在癌症诊断时，中位 CD4T 细胞计数为 318（IQR 159-690）细胞/µl，40.7%的患者在癌症诊断时存在严重免疫抑制，CD4 计数低于 200 细胞/µl。
非 AIDS 定义的癌症比 AIDS 定义的癌症更为常见，这表明由于 ART 的普及，患者的寿命延长了。HIV 感染患者的癌症患病率为 9%，且呈时间趋势增加；这突出表明，必须在这一弱势群体中促进癌症筛查，并实施针对肝癌和宫颈癌的疫苗接种计划以及针对与吸烟有关癌症的控烟政策。
