Cancer incidence in HIV patients under HAART therapy in a HIV-1 F1 subtype endemic area

Cancers have been recognized as a major health problem in patients with HIV. The first cases reported, before the existence of the virus was proven, involved patients with immunosuppression and a history of illness characterized by fever, weight loss and/or lymphadenopathy lasting weeks of months. As the population grows older, a consequence of better and largely available treatments, the impact of non-AIDS-defining cancers (NADC) is having a greater impact on the management of HIV infected patients. Studies of different subtypes of HIV-1 in Romania show a very high prevalence of subtype F1, with values between 70% - 90% or the patients being infected with this strain. The study of HIV infected population in Romania is important for identifying particularities of the subtype F1 evolution.

We conducted a prospective study on HIV positive patients under HAART treatment from the Constanta Regional Centre, for a period of eight years, between 2007-2015. All causes of new discovered cancers were recorded with the occasion of subsequent visits that are done on a regular basis. For comparison we used official data from of new diagnosed cancers from reports on health status for Constanta County for the same time period. The adjusted incidence ratio is 955.18/100000patient-years (95% CI 446.58 – 1463.75/100000 patient-years). As observed in similar studies conducted.

HIV patients that undergo HAART treatment have an increased risk of all cancers significantly higher than what is observed in the general population. Considering this, better screening programs have to be developed and implemented for this population. Also, because of the suspicioned high number of HIV infected patients that are not diagnosed, a screening program for HIV should be implemented for all newly diagnosed patients with any type of malignancy.