[Neoplasms associated with human immunodeficiency virus infection. Study of the clinical course of 70 patients].

BACKGROUND

A different epidemiologic pattern of the neoplasms associated to the human immunodeficiency virus (HIV) has been described in the Mediterranean area. The aim of the present study was to analyze the epidemiologic, clinical and evolutive characteristics of these patients.

METHODS

A retrospective study of 74 neoplasms in 70 patients (15% of AIDS cases) was carried out. The following variables were analyzed: risk group, state of the infection (HIV), stage and type of tumor, immunohematologic data, opportunistic infections (OI), response to treatment, evolution and prognostic factors.

RESULTS

Thirty-four Kaposi's sarcomas (SK) were diagnosed, 32 non Hodgkin's lymphomas (NHL), 4 Hodgkin's disease (HD), 2 seminomas, 1 cutaneous carcinoma and one undifferentiated tumor. Sixty-eight patients were males with a mean age of 32 years. The risk group was: homosexual (52%), drug abuse (24%), hemophilia (14%), and heterosexual contact (10%). The neoplasm was the first manifestation of HIV infection in 60% of the patients. Sixteen patients with SK were treated with chemotherapy (CMT), radiotherapy (RT) or interferon and stabilization of the disease was achieved in 50% of the cases. Twenty-six patients with NHL received treatment: 26 with CMT, 9 with RT and 4 with surgery. Complete remission was achieved in 27% and partial in 61% of the cases. Overall mortality was 56% and median survival 13 months. Most of the patients died due to progression of the tumor or infection. The prognostic factors associated to shortened survival were: advanced stage of AIDS, OI at the time of diagnosis of the tumor and a decrease in hemoglobin, total lymphocytes and CD4.

CONCLUSIONS

The lower incidence of neoplasms among patients with acquired immunodeficiency disease and the differences in the distribution of the histologic types may be related with the demographic features of the risk groups in Spain. Survival is determined more by opportunistic infections than by the tumor itself.