Background: The introduction of highly active antiretroviral therapy (HAART) has influenced the incidence of cancer in people with human immunodeficiency virus (HIV) infection. The aim of this study was to evaluate changes in the pattern of cancer rates in HIV-infected children on HAART during over a decade of follow-up.
Patients and Methods: We carried out a case-control study. Data were obtained from the records of the minimum basic data set of hospitals in Spain from 1999 to 2008. The epidemiologic trends of cancer diagnoses were evaluated through 3 calendar periods: early-period HAART: 1997–1999, midperiod HAART: 2000–2002, and late-period HAART: 2003–2008).
Results: HIV-infected children had higher rates of cancer diagnosis than HIV-negative children (P < 0.001) for both acquired immunodeficiency disease syndrome (AIDS)-defining malignancies (ADM) and non-AIDS-defining malignancies (non-ADM). The highest rates of cancer diagnosis in HIV-positive children were for non-Hodgkin lymphoma, malignant neoplasm of bone and articular cartilage, and Hodgkin lymphoma. When we compared the 3 calendar periods, we found that the rate of ADM diagnoses decreased (from 9.1 to 3.6 to 1.0 cancers per 1000 HIV-children/yr; P < 0.05) and that the rate of non-ADM diagnoses increased (from 0.6 to 5.0 to 8.7 cancers per 1000 HIV-children/yr; P < 0.05). Moreover, the overall rate of cancer diagnoses (ADM plus non-ADM) did not change during the study period (9.7, 8.7, and 9.7 cancers per 1000 HIV-children/yr).
Conclusions: HIV-infected children had a dramatic decrease in the rate of ADM diagnoses and an increase in the rate of non-ADM diagnoses. The overall cancer diagnosis rate has not decreased during the past decade and the incidence of cancer still remains high in HIV-infected children in Spain.
From the *Unidad de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; †Laboratorio de Epidemiología Molecular de Enfermedades Infecciosas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; ‡Servicio de Pediatría, Hospital Infanta Cristina, Parla, Madrid, Spain; and §Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
Accepted for publication March 21, 2011.
Supported by Fundación para la Investigación y la Prevención del SIDA en España (FIPSE) (Ref. 36650/07) and Instituto de Salud Carlos III (Ref. PI08/0738) grant (to S.R.). Instituto de Salud Carlos III grant (CM08/00101) (to M.G.A.).
The authors do not have a commercial or other association that might pose a conflict of interest.
Address for correspondence: Salvador Resino, PhD, Laboratorio de Epidemiología Molecular de Enfermedades Infecciosas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo, Km 2.2, 28220 Majadahonda, Madrid, Spain. E-mail: firstname.lastname@example.org.
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