2244. Non-AIDS Cancers Contribute to an Increasing Proportion of Deaths in Persons Living with HIV at a Single University-Based Clinic
Session: Poster Abstract Session: HIV: Malignancy
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Non AIDS Cancers Contribute to an Increasing Proportion of Deaths in Persons Living with HIV at a Single University Based Clinic.pdf (516.1 kB)
  • Non-AIDS Cancers Contribute to an Increasing Proportion of Deaths in Persons Living with HIV at a Single University-Based Clinic

    Adam M Ressler, MD; Steven Johnson, MD; Mona Abdo; Samantha MaWhinney, ScD; Kristine M. Erlandson, MD

    Background:

    Mortality for people living with HIV (PLWH) has drastically decreased since the mid-1990s, and the proportion of deaths due to non-HIV related conditions has increased.

    Methods:

    Deceased PLWH were identified within a single academic medical center. Cause of death was determined by chart review, clinic providers, and when available autopsy and toxicology data. Chart review of comorbidities, demographics and preventable causes of cancer was conducted for deaths during the period of 2013-2017.

    Results:

    The proportion of AIDS-related deaths decreased markedly between 1995 and 2017, while the proportion of deaths from non-AIDS cancers has increased (Figure).  Patients with non-AIDS cancers were older, had a higher CD4 count and greater proportion with undetectable viral load, and were more likely to be male; over 80% were current or prior smokers (Table).   Among all deaths from 2013-2017, 44% of eligible patients received colon cancer screening, 66% received cervical cancer screening, and 29% received breast cancer screening. Of patients who died from HCC, 1 out of 6 had imaging for HCC within 1 year and none within 6 months of diagnosis.

    Conclusion:

    Improvements in cancer screening and preventative health measures including smoking cessation and lifestyle improvement education may help to reduce the increasing proportion of non-AIDS cancer-related deaths among PLWH.

     

    Characteristics by Cause of Death (2013-2017)

     

    HIV-Related

    Cancer ‡

    P-value

    n

    22

    24

     

    Age at Death

    50 (44, 56)

    56 (53, 61)

    0.03

    Last Available CD4

    72(15, 249)

    207(94, 301.5)

    0.02

    Last Available Viral Load < 50 Copies

    5 (23)

    16 (67)

    0.004

    CD4 Nadir

    18(7, 110)

    77(35, 126)

    0.2

    Male

    14 (64)

    23 (96)

    0.009

    Smoking Within 1 Year of Death

    9 (41)

    13 (54)

    0.8

    Smoking, Quit 1-15 Years Prior to Death

    5 (23)

    6 (25)

    Smoking, Quit > 15 Years Prior to Death

    1 (5)

    1 (4)

    Never Smoked

    7 (32)

    4 (17)

    *Median (IQR) or n (%)

    ‡ Most Common: HCC (6), Head/Neck (4), Prostate (3)

     

    Adam Ressler, MD1, Steven C. Johnson, MD2, Mona Abdo, MPH3, Samantha MaWhinney, ScD3 and Kristine Erlandson, MD4, (1)University of Colorado School of Medicine, AURORA, CO, (2)University of Colorado School of Medicine, Aurora, CO, (3)Colorado School of Public Health, University of Colorado Anschutz Medical Campus, AURORA, CO, (4)University of Colorado Denver-Anschutz Medical Campus, Aurora, CO

    Disclosures:

    A. Ressler, None

    S. C. Johnson, None

    M. Abdo, None

    S. MaWhinney, None

    K. Erlandson, None

    See more of: HIV: Malignancy
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.