Patterns of neoplastic diseases among HIV-infected and HIV-uninfected patients

Abstract

Abstract: In order to investigate the association between the human immunodeficiency virus (HIV) type-1 and neoplasms, we analyzed the pattern and rates of neoplastic disorders among HIVpositive and HIV-negative patients. A total of 108 incident neoplastic diseases were diagnosed among 4272 subjects tested for HIV at Tikur Anbessa Teaching Hospital, Addis Ababa, from September 1994 to March 1997. Forty-eight (1.1%) incident tumors were diagnosed among 2701 patients seropositive for antibodies to HIV-1 and 60 (1.4%) among 1573 seronegatives. There was no statistical diferrence on the occurrence of tumor in the HIV-positive or HIV-negative subjects (Odds ratio=0.48; 95% confidence interval=0.32,0.72). Kaposi's sarcoma (KS) was the most frequent neoplastic disease among HIV-positive subjects (47.9%) and it was strongly associated with HIV seropositivity (Odds ratio=13.5; 95% confidence interval=1.95, 268.99). Non-Hodgkin's lymphoma (NHL) (22.9%) and Hodgkin's disease (HD) (18.8%) were the other frequent neoplasms. Most (73%) of the HIV-related NHL were of the high grade type;64% of these tumors were extranodal and 55.6% of all NHL occurring in HIV-negative subjects were of the high grade type;only 33.3% were extranodal. NHL of the low grade type was less frequent in HIV- positive subjects compared to HIV-negative subjects (9.1 vs. 25.9%; Odds ratio= 4.08;95% confidence interval 0.51,88.42). Significant cases of cervical carcinomas (37.5%), classified histologicaly as sqamous cell carcinomas, were associated with HIV infection, although it was not statisticaly significant (Odds ratio=0.44;95% confidence interval=0.08,2.29). In the HIV-uninfected subjects, NHL was the most common neoplasm (45%) followed by HD (15%), hematological malignancies (10.1%) and cervical carcinomas (8.3%). Data from the present study demonstrate that some neoplasms are frequently associated with the current trends of the HIV/AIDS epidemic in Ethiopia. Many new AIDS-related neoplasms will likely continue to be identified in the future. [Ethiop. J. Health Dev. 1998;12(2):117-123]