Malignancies Spectrum in the Era of Modern HAART

Abstract

In the current highly active antiretroviral therapy (HAART) era, studies suggest AIDS defining malignancies (ADM) are decreasing and non- AIDS defining malignancies (NADM) are increasing. We aimed to review all types of malignancies and risk factors in our HIV cohort over a period of ten years. Methods T his was a retrospective cohort study of all malignancy diagnoses and risk factors collected (2004-2014) from two teaching hospitals in the Midlands, United Kingdom. The demographic data and clinical features were collated and the primary end point of survival analysed. Secondary endpoints included risk factors for ADM compared to NADM. Results 111malignancy diagnoses 63 (54%) ADM and 48 (46%) NADM identified. Survival was worse once diagnosed with a NADM. About half of the ADM and a third of the NADM had a new HIV diagnosis at the same time or soon after the malignancy diagnosis. Haematological malignancies were the commonest malignancy in both groups. Oncogenic virus was an independent predictor of ADM risk . Conclusions Despite new and improved HAART regimens, ADM remain high in newly diagnosed HIV individuals and NADM are on the rise in those on longstanding HAART with stable HIV. Not only continuing HIV testing in new ADM as per the indicator conditions, but it is also important to increase HIV testing in new diagnoses of NADM such as all haematological malignancies and lung cancer.