Cargando…

Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV

BACKGROUND: Adults living with HIV have an increased risk of malignancy yet there is a paucity of data for adolescents and young adults (AYA) with perinatally acquired HIV (PaHIV). METHODS: Retrospective cohort analysis of all-cause mortality and malignancies in AYA with PaHIV aged 10–24 years atten...

Descripción completa

Detalles Bibliográficos
Autores principales: Chhabra, Srishti, Fidler, Sarah, Ayers, Sara, Bower, Mark, Lyall, Hermione, Foster, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mediscript Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043901/
https://www.ncbi.nlm.nih.gov/pubmed/32175089
_version_ 1783501468243853312
author Chhabra, Srishti
Fidler, Sarah
Ayers, Sara
Bower, Mark
Lyall, Hermione
Foster, Caroline
author_facet Chhabra, Srishti
Fidler, Sarah
Ayers, Sara
Bower, Mark
Lyall, Hermione
Foster, Caroline
author_sort Chhabra, Srishti
collection PubMed
description BACKGROUND: Adults living with HIV have an increased risk of malignancy yet there is a paucity of data for adolescents and young adults (AYA) with perinatally acquired HIV (PaHIV). METHODS: Retrospective cohort analysis of all-cause mortality and malignancies in AYA with PaHIV aged 10–24 years attending a tertiary unit from 01 January 2004 to 31 December 2017, assessing cancer presentation, immunology and comparing mortality and malignancy incidence to age-matched UK general population rates. RESULTS: A total of 290 AYA with PaHIV contributed 2644 person-years of follow up. Six (2.0%) died within the study period at a median age of 17 years (interquartile range [IQR]15–19), 3 of malignancy, 2 with end-stage HIV and 1 with cryptococcal meningitis. Overall mortality rate was 2.3/1000 person-years, with an age-matched general population rate of 0.2/1000 person-years. Eight (2.8%) were diagnosed with a malignancy; 6 with lymphoma (n=3 Hodgkin's, n=1 Burkitt's, n=2 B-cell) and one each with hepatocellular carcinoma and gastrointestinal adenocarcinoma. At cancer diagnosis the median age was 19 years (IQR 14–23), median CD4 T cell count was 453 cells/mm(3) (IQR 231–645) and median length of HIV viremia was 15 years (IQR 12–17). The incidence rate of a malignancy was 3.0/1000 person-years in AYA with PaHIV, whilst that in the age-matched general population is 0.2/1000 person-years. CONCLUSION: AYA living with PaHIV had an increased risk of all-cause mortality and of malignancy compared to their uninfected peers, with the excess in malignancy driven by lymphomas. It is hoped that earlier access to antiretroviral therapy will mitigate some of the AIDS-defining and non-AIDS defining risks for future generations.
format Online
Article
Text
id pubmed-7043901
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Mediscript Ltd
record_format MEDLINE/PubMed
spelling pubmed-70439012020-03-13 Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV Chhabra, Srishti Fidler, Sarah Ayers, Sara Bower, Mark Lyall, Hermione Foster, Caroline J Virus Erad Viewpoint BACKGROUND: Adults living with HIV have an increased risk of malignancy yet there is a paucity of data for adolescents and young adults (AYA) with perinatally acquired HIV (PaHIV). METHODS: Retrospective cohort analysis of all-cause mortality and malignancies in AYA with PaHIV aged 10–24 years attending a tertiary unit from 01 January 2004 to 31 December 2017, assessing cancer presentation, immunology and comparing mortality and malignancy incidence to age-matched UK general population rates. RESULTS: A total of 290 AYA with PaHIV contributed 2644 person-years of follow up. Six (2.0%) died within the study period at a median age of 17 years (interquartile range [IQR]15–19), 3 of malignancy, 2 with end-stage HIV and 1 with cryptococcal meningitis. Overall mortality rate was 2.3/1000 person-years, with an age-matched general population rate of 0.2/1000 person-years. Eight (2.8%) were diagnosed with a malignancy; 6 with lymphoma (n=3 Hodgkin's, n=1 Burkitt's, n=2 B-cell) and one each with hepatocellular carcinoma and gastrointestinal adenocarcinoma. At cancer diagnosis the median age was 19 years (IQR 14–23), median CD4 T cell count was 453 cells/mm(3) (IQR 231–645) and median length of HIV viremia was 15 years (IQR 12–17). The incidence rate of a malignancy was 3.0/1000 person-years in AYA with PaHIV, whilst that in the age-matched general population is 0.2/1000 person-years. CONCLUSION: AYA living with PaHIV had an increased risk of all-cause mortality and of malignancy compared to their uninfected peers, with the excess in malignancy driven by lymphomas. It is hoped that earlier access to antiretroviral therapy will mitigate some of the AIDS-defining and non-AIDS defining risks for future generations. Mediscript Ltd 2020-02-20 /pmc/articles/PMC7043901/ /pubmed/32175089 Text en © 2019 The Authors. Journal of Virus Eradication published by Mediscript http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article published under the terms of a Creative Commons License.
spellingShingle Viewpoint
Chhabra, Srishti
Fidler, Sarah
Ayers, Sara
Bower, Mark
Lyall, Hermione
Foster, Caroline
Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title_full Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title_fullStr Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title_full_unstemmed Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title_short Malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired HIV
title_sort malignancy and all-cause mortality; incidence in adolescents and young adults living with perinatally acquired hiv
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043901/
https://www.ncbi.nlm.nih.gov/pubmed/32175089
work_keys_str_mv AT chhabrasrishti malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv
AT fidlersarah malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv
AT ayerssara malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv
AT bowermark malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv
AT lyallhermione malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv
AT fostercaroline malignancyandallcausemortalityincidenceinadolescentsandyoungadultslivingwithperinatallyacquiredhiv