435. A Seven-Year Review of AIDS and Non-AIDS related Malignancies in a Large HIV/AIDS Center in New York
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Background:

Due to the advent of potent antiretroviral therapy (HAART) and increased longevity of HIV-infected patients, malignancies are being diagnosed frequently with an increasing number attributed to non-AIDS-defining cancers.

Methods:

A retrospective chart review of 4,874 adult HIV-infected patients from 1/1/2003 to 12/31/2009 was performed. 239 patients were diagnosed with neoplastic diseases.  Demographical and HIV related data, viral hepatitis serologies, histopathology, tobacco history and treatment outcomes were analyzed.

Results:

The incidence of malignancies was 4.9 % (239/4,874).  Characteristics of the cohort: mean age-49 (range 21-77), 78 % were male, 48 % Black, 25 % White and 27 % Latino. Risk factors for HIV: 45 % MSM, 25 % IVDU, 29 % heterosexual, 1 % perinatal. 53 % had used tobacco, 28 % had Hepatitis C and 14 % had Hepatitis B co-infections. At cancer diagnosis the mean CD4 T-cell count was 229/µL (range 2-1011), median CD4 of 186/µL; mean HIV viral load log10 4.69; median log10 2.83. The mean CD4 T-cell count  in AIDS defining tumors vs. non AIDS was 170 vs. 291, P value: 0.0003.  73 % of patients were on HAART and 51 % died from cancer.

93 of 239 (39 %) malignancies were AIDS- related: Non-Hodgkin’s Lymphoma-60; Kaposi’s Sarcoma-32; Cervical cancer-1.

146 of 239 (61 %) were non-AIDS related: Lung-28 (adenocarcinoma 13, squamous cell 13, small cell 2); Prostate adenocarcinoma-20; Hodgkin’s Lymphoma-15; Anorectal-13 (squamous cell 11, adenocarcinoma 2); Liver cancer-8.

Other non-AIDS related malignancies: Gastrointestinal-22  (colon 6, pancreas 5, tongue 4, stomach 2, biliary tract 2, esophagus 1, klatskin tumor 1, tonsil 1); Genitourinary-14  (kidney 3, vulva 2, scrotum 2, testis 2, ovary 2, vagina 1, penis 1, urethra 1); Nervous system-astrocytoma 1; Hematologic-7  (leukemia 3, multiple myeloma 2, plasmacytoma 2); Breast-6; Unknown primary-6; Skin-4; Thyroid-2.

Conclusion:

A higher rate of non-AIDS related cancers was recognized, with lung and prostate tumors the most frequently observed. Cancer prevention, age-appropriate screening, and promotion of risk-reduction behaviors (e.g. tobacco cessation) need to be implemented to facilitate earlier disease recognition and optimal treatment strategies as patients with HIV live longer.


Subject Category: H. HIV/AIDS and other retroviruses

Venkata K. Pokuri, MD1, Costantine Albany, MD2, George Jr Psevdos, MD3, Josephine Paredes, MD3 and Victoria Sharp, MD3, (1)Internal Medicine, St.Luke's Roosevelt Hospital Center, New York, NY, (2)St.Luke's Roosevelt Hospital Center, New York, NY, (3)Center for Comprehensive Care, St.Luke's-Roosevelt Hospital Center, New York, NY

Disclosures:

V. K. Pokuri, None

C. Albany, None

G. J. Psevdos, None

J. Paredes, None

V. Sharp, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.