Cancer Incidence, Risk Factors, and Survival in a 31 Years-Old Brazilian HIV Cohort

Abstract

This study aimed to report cancer incidence and mortality in a Brazilian human immunodeficiency virus (HIV) cohort of 31?years duration and compare cancer deaths with deaths due to noncancer causes. We also investigated risk factors for the development of acquired immunodeficiency syndrome (AIDS)-defining and non-AIDS-defining cancers. We searched for any information related to the diagnosis of cancer in a period ranging from 1989 to 2020. We also collected data on sociodemographic and clinical information and risk factors. Statistical analysis included parametric and nonparametric tests and the building of survival curves. We used the statistical software GraphPad software (version 9) and STATA software (version 14) for the elaboration of statistics. Fifty-five new cases of cancer occurred in a total of 677 HIV patients included in our cohort over 31?years, an incidence of 8.12%. The most important risk factors associated with cancer were smoking (p = 0.03), infection with oncoviruses like human papillomavirus (p < 0.001), and hepatitis C (p = 0.04). Eleven patients (1.6%) died from cancer. The most frequent diagnoses of fatal cancer were liver cancer and lymphoma (three cases each). The mean follow-up time of patients dying from cancer was 14?years; patients dying from noncancer causes were 24 (3.55%), and their mean follow-up time was 11?years. We had low overall mortality in our cohort of HIV patients (5.2%), mostly due to noncancer causes, which may be due to the fact that most of our patients begin follow-up asymptomatic. Cancer deaths were 31.4% of all deaths; half of those cancers were AIDS-defining.

Keywords

• HIV
• cancer
• risk factors
• Brazil
• mortality
• morbidity