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Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study

AIDS-related mortality declined markedly since the introduction of antiretroviral therapy (ART); however, cancer mortality in Africa was higher than its incidence in 2020. People living with HIV (PLWHIV) are at an increased risk of malignancy and death from malignancy compared with the general popul...

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Autores principales: Kauma, Geraldine, Ddungu, Henry, Ssewanyana, Isaac, Nyesiga, Sharon, Bogere, Naghib, Namulema-Diiro, Teddy, Byakika-Kibwika, Pauline, Namukwaya, Elizabeth, Kizza, Harriet Mayanja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281357/
https://www.ncbi.nlm.nih.gov/pubmed/37043709
http://dx.doi.org/10.1200/GO.22.00262
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author Kauma, Geraldine
Ddungu, Henry
Ssewanyana, Isaac
Nyesiga, Sharon
Bogere, Naghib
Namulema-Diiro, Teddy
Byakika-Kibwika, Pauline
Namukwaya, Elizabeth
Kizza, Harriet Mayanja
author_facet Kauma, Geraldine
Ddungu, Henry
Ssewanyana, Isaac
Nyesiga, Sharon
Bogere, Naghib
Namulema-Diiro, Teddy
Byakika-Kibwika, Pauline
Namukwaya, Elizabeth
Kizza, Harriet Mayanja
author_sort Kauma, Geraldine
collection PubMed
description AIDS-related mortality declined markedly since the introduction of antiretroviral therapy (ART); however, cancer mortality in Africa was higher than its incidence in 2020. People living with HIV (PLWHIV) are at an increased risk of malignancy and death from malignancy compared with the general population. In Uganda, AIDS-defining malignancies (ADMs), including cervical cancer, Kaposi sarcoma, and non-Hodgkin lymphoma, are among the commonest malignancies. Virologic nonsuppression has been identified as an important predictor of mortality among PLWHIV diagnosed with cancer. This study aimed to determine the prevalence and to identify factors associated with virologic nonsuppression among PLWHIV newly diagnosed with cancer. METHODS: This was a cross-sectional study that was carried out between December 2018 and April 2019 at the Uganda Cancer Institute. PLWHIV who had been on ART for at least 6 months and were newly diagnosed with cancer were enrolled. RESULTS: A total of 167 participants were enrolled. Cervical cancer was the commonest ADM (n = 45; 50.6%) of all ADMs, while esophageal and breast cancers were the commonest non-ADMs, accounting for 17.5% (n = 14) each of all non-ADMs. The prevalence of virologic nonsuppression was 15%. Having Kaposi sarcoma (odds ratio [OR], 8.15; P = .003), being poorly adherent to ART (OR, 4.1; P = .045), and being on second-line ART (OR, 5.68; P = .011) were associated with virologic nonsuppression. CONCLUSION: The prevalence of virologic nonsuppression is high among patients with HIV newly diagnosed with cancer. These findings emphasize the need for strengthening of adherence strategies, optimizing ART regimens, and prioritization of viral load testing among PLWHIV with newly diagnosed malignancy.
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spelling pubmed-102813572023-06-21 Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study Kauma, Geraldine Ddungu, Henry Ssewanyana, Isaac Nyesiga, Sharon Bogere, Naghib Namulema-Diiro, Teddy Byakika-Kibwika, Pauline Namukwaya, Elizabeth Kizza, Harriet Mayanja JCO Glob Oncol ORIGINAL REPORTS AIDS-related mortality declined markedly since the introduction of antiretroviral therapy (ART); however, cancer mortality in Africa was higher than its incidence in 2020. People living with HIV (PLWHIV) are at an increased risk of malignancy and death from malignancy compared with the general population. In Uganda, AIDS-defining malignancies (ADMs), including cervical cancer, Kaposi sarcoma, and non-Hodgkin lymphoma, are among the commonest malignancies. Virologic nonsuppression has been identified as an important predictor of mortality among PLWHIV diagnosed with cancer. This study aimed to determine the prevalence and to identify factors associated with virologic nonsuppression among PLWHIV newly diagnosed with cancer. METHODS: This was a cross-sectional study that was carried out between December 2018 and April 2019 at the Uganda Cancer Institute. PLWHIV who had been on ART for at least 6 months and were newly diagnosed with cancer were enrolled. RESULTS: A total of 167 participants were enrolled. Cervical cancer was the commonest ADM (n = 45; 50.6%) of all ADMs, while esophageal and breast cancers were the commonest non-ADMs, accounting for 17.5% (n = 14) each of all non-ADMs. The prevalence of virologic nonsuppression was 15%. Having Kaposi sarcoma (odds ratio [OR], 8.15; P = .003), being poorly adherent to ART (OR, 4.1; P = .045), and being on second-line ART (OR, 5.68; P = .011) were associated with virologic nonsuppression. CONCLUSION: The prevalence of virologic nonsuppression is high among patients with HIV newly diagnosed with cancer. These findings emphasize the need for strengthening of adherence strategies, optimizing ART regimens, and prioritization of viral load testing among PLWHIV with newly diagnosed malignancy. Wolters Kluwer Health 2023-04-12 /pmc/articles/PMC10281357/ /pubmed/37043709 http://dx.doi.org/10.1200/GO.22.00262 Text en © 2023 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
spellingShingle ORIGINAL REPORTS
Kauma, Geraldine
Ddungu, Henry
Ssewanyana, Isaac
Nyesiga, Sharon
Bogere, Naghib
Namulema-Diiro, Teddy
Byakika-Kibwika, Pauline
Namukwaya, Elizabeth
Kizza, Harriet Mayanja
Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title_full Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title_fullStr Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title_full_unstemmed Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title_short Virologic Nonsuppression Among Patients With HIV Newly Diagnosed With Cancer at Uganda Cancer Institute: A Cross-Sectional Study
title_sort virologic nonsuppression among patients with hiv newly diagnosed with cancer at uganda cancer institute: a cross-sectional study
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281357/
https://www.ncbi.nlm.nih.gov/pubmed/37043709
http://dx.doi.org/10.1200/GO.22.00262
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