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

adolescents lymphoma malignancy mortality perinatally acquired HIV

Journal

Journal of virus eradication
ISSN: 2055-6640
Titre abrégé: J Virus Erad
Pays: England
ID NLM: 101654142

Informations de publication

Date de publication:
20 Feb 2020
Historique:
entrez: 17 3 2020
pubmed: 17 3 2020
medline: 17 3 2020
Statut: epublish

Résumé

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). 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. 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 ( 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.

Sections du résumé

BACKGROUND 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 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 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 (
CONCLUSION CONCLUSIONS
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.

Identifiants

pubmed: 32175089
pmc: PMC7043901

Types de publication

Editorial

Langues

eng

Pagination

30-33

Informations de copyright

© 2019 The Authors. Journal of Virus Eradication published by Mediscript.

Références

Curr Opin HIV AIDS. 2016 Sep;11(5):487-491
pubmed: 27465878
Clin Infect Dis. 2016 Nov 1;63(9):1245-1253
pubmed: 27578823
Lancet Oncol. 2016 Jul;17(7):896-906
pubmed: 27237614
AIDS. 2016 Jan 2;30(1):153-6
pubmed: 26558727
AIDS. 2015 Oct 23;29(16):2173-81
pubmed: 26182198
Curr Opin HIV AIDS. 2018 May;13(3):196-203
pubmed: 29461329
Curr Opin HIV AIDS. 2018 May;13(3):212-219
pubmed: 29570471
Lancet HIV. 2017 Nov;4(11):e495-e504
pubmed: 28803888
Pediatr Infect Dis J. 2017 Dec;36(12):1156-1158
pubmed: 28650418
Curr Opin HIV AIDS. 2017 Jan;12(1):12-19
pubmed: 27755153
J Acquir Immune Defic Syndr. 2016 Jun 1;72(2):177-83
pubmed: 26859827
PLoS One. 2013;8(2):e55630
pubmed: 23405184
Blood. 2011 Jun 9;117(23):6100-8
pubmed: 21368291
PLoS One. 2017 Oct 31;12(10):e0186549
pubmed: 29088223
HIV Med. 2014 Apr;15(4):239-44
pubmed: 24112550
Clin Infect Dis. 2016 Dec 15;63(12):1668-1676
pubmed: 27609756
J Int AIDS Soc. 2017 May 16;20(Suppl 3):21520
pubmed: 28530036
Paediatr Child Health. 2006 Feb;11(2):103-6
pubmed: 19030262

Auteurs

Srishti Chhabra (S)

Imperial College London Faculty of Medicine, London, UK.

Sarah Fidler (S)

Imperial College London Faculty of Medicine, London, UK.
Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.

Sara Ayers (S)

Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.

Mark Bower (M)

Imperial College London Faculty of Medicine, London, UK.
Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

Hermione Lyall (H)

Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.

Caroline Foster (C)

Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.

Classifications MeSH