Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

2008 ◽  
Vol 26 (3) ◽  
pp. 474-479 ◽  
Author(s):  
Elizabeth Y. Chiao ◽  
Thomas P. Giordano ◽  
Peter Richardson ◽  
Hashem B. El-Serag
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Cell Cancer ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Hiv Positive ◽  
Highly Active ◽  
Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

Prevalence of Plantar Verrucae in Patients with Human Immunodeficiency Virus Infection During the Post–Highly Active Antiretroviral Therapy Era

2011 ◽  
Vol 101 (1) ◽  
pp. 35-40 ◽  
Author(s):  
James Johnston ◽  
Christy M. King ◽  
Sky Shanks ◽  
Saieh Khademi ◽  
Joseph Nelson ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Logistic Regression ◽  
Antiretroviral Therapy ◽  
Life Expectancy ◽  
Confidence Interval ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Positive ◽  
Highly Active ◽  
Immunodeficiency Virus

Background: Since the implementation of highly active antiretroviral therapy (HAART), the life expectancy of patients with human immunodeficiency virus (HIV) has significantly increased. This is likely to cause changes in podiatric medical manifestations, such as plantar verrucae, in this population. Methods: Attendees at a San Francisco street fair in 2008 provided information about HIV status and the presence of verrucae via a survey. A total of 504 surveys were analyzed and compared with 1995 data, before HAART implementation. We examined if there was a statistically significant change in the increased likelihood of plantar verrucae in HIV-positive patients from 1995 to 2008. Then we examined the likelihood of HIV-positive patients (compared to HIV-negative patients) presenting with plantar verrucae in 2008, by using logistic regression, and controlling for age, sex, and race/ethnicity. Results: Patients with HIV infection were 5.2 times more likely to present with plantar verrucae compared to patients without HIV infection in 2008 (95% confidence interval, 2.5–11.0, P &lt; .0001) and 10.0 times more likely in 1995 (95% confidence interval, 3.4–29.0, P &lt; .0001). This decrease in likelihood over time was not statistically significantly different (P = .33). Logistic regression analysis controlling for the covariates of age, race, and sex showed that patients with HIV in 2008 were 4.5 times more likely to present with verrucae compared to patients without HIV (95% confidence interval, 2.1–9.9, P = .0002). Conclusions: Patients with HIV infection in 2008 are still significantly more likely to present with plantar verrucae after controlling for age, race, and sex. This increased likelihood has not changed significantly across time. Because HAART has increased the life expectancy of patients with HIV, this group of patients with plantar verrucae will continue to represent a significant population in the practice of podiatric medicine. (J Am Podiatr Med Assoc 101(1): 35–40, 2011)

scholarly journals Squamous Cell Carcinoma of the Lower Lip Complicating a Recurrent Labial Herpes During HIV Infection: a Case Report

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Hiv Infection ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Surgical Excision ◽  
Hiv Positive ◽  
Epithelial Tumor ◽  
Lower Lip ◽  
Highly Active

Introduction: Squamous cell carcinoma (SCC) is the main cancer of lips; it is increasingly diagnosed in HIV-positive patients. In most cases, there are factors that promote his occurrence. We report a case of an HIV-positive woman with SCC of the lower lip complicating recurrent labial herpes. Medical observation: It was a case of a 40-year-old female received in consultation for a painful and ulcerous lesion of her lip lasting 5 months. She was a HIV-positive patient diagnose since 2007 and on Highly Active Antiretroviral Therapy since that time. She was taking alcohol, was exposed to sunlight regularly, and had presented many episodes of labial herpes in the past. On clinical examination she had a painful ulcero-crustal medallion measuring 2.5 centimeters in diameter, with a papular edge of pearlescent appearance of the lower lip. Given this clinical picture, the diagnosis of chronic decaying herpes labialis with in differential an epithelial tumor (in particular a squamous cell carcinoma of the lower lip) was mentioned. After surgical excision, an anatomopathological analysis of the part confirmed the diagnosis of squamous cell carcinoma. At the time of diagnosis, the patient had a respective CD4 and CD8 level of 939 and 964 cells / mm3 . The evolution was marked 6 weeks later by the scarring with complete epithelialization of the site of the lesion. Conclusion: SCC of the lips is a frequent cancer occurring during HIV infection; there are many risk factors which promote his occurrence. Earlier the treatment is instituted, better is the prognosis.

scholarly journals Liver disease, HIV and aging

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 512 ◽  
Author(s):  
Oluwaseun Falade-Nwulia ◽  
Chloe L. Thio
Keyword(s):  
Liver Disease ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Future Research ◽  
Hiv Replication ◽  
Highly Active ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Negative

The life expectancy of HIV-infected patients has increased due to the efficacy of highly active antiretroviral therapy (HAART) in controlling HIV replication; thus, the population living with HIV infection is steadily aging. Liver-related morbidity and mortality has emerged as a leading problem in HIV-infected patients. Since aging, HIV infection and HAART all affect the liver, understanding the impact of the combination of these factors on liver disease is crucial for optimisation of care in the aging HIV-infected population. This review will focus on the current understanding of liver disease in older (>50 years old) HIV-negative individuals and in HIV-infected individuals. Areas for future research in the area of HIV, liver disease and aging will also be discussed.

scholarly journals Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women

2018 ◽  
Vol 37 (3) ◽  
pp. 181
Author(s):  
Evarista Odaburhine Osime ◽  
Catherine Obar
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Protein C ◽  
Protein S ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hiv Positive ◽  
Highly Active ◽  
The Impact ◽  
Hiv Negative

<p><strong>BACKGROUND</strong></p><p>Various studies have examined optimal methods for Prevention of Mother to Child Transmission (PMTCT) of human immunodeficiency virus (HIV) and subsequent outcome of response to highly active antiretroviral therapy (HAART) as well as the impact of pregnancy on outcomes of HIV in the Pre-HAART era. Little is known of the impact of pregnancy in response to HAART in Africa. This study is aimed to evaluate euglobulin lysis time (ELT), protein C and protein S in HIV-positive pregnant women on HAART.</p><p><strong> </strong></p><p><strong>METHODS</strong></p><p>This was a cross-sectional study comprised of 150 participants attending Ante-Natal Clinic (ANC) in Central Hospital, Benin City. Pregnant women on HAART (Test subjects) (n=50, mean age 34 years), 50 pregnant newly diagnosed HIV-positive women that had not yet commenced HAART (n=50, mean age 31 years) and 50 pregnant HIV-negative women (n=50, mean age 30 years) which served as controls. The ELT was determined by methods described by Bain, protein C and protein S were determined using Enzyme Linked Immunosorbent Assay (ELISA).</p><p><strong> </strong></p><p><strong>RESULTS</strong></p><p>There was a significant increase in ELT in both pregnant women on HAART and not on HAART) when compared to HIV-negative pregnant women (p&lt;0.05). There was a significant decrease in protein C in test subjects when compared with controls (p&lt;0.05) and protein S increased significantly in HIV-positive pregnant women on HAART when compared to those not on HAART and HIV-negative pregnant women (p&lt;0.05).<strong> </strong></p><p><strong> </strong></p><p><strong>CONCLUSION</strong></p>There are changes in ELT, protein C and protein S parameters with the introduction of HAART in pregnancy.

scholarly journals HIV Status Does Not Influence Outcome in Patients With Classical Hodgkin Lymphoma Treated With Chemotherapy Using Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine in the Highly Active Antiretroviral Therapy Era

2012 ◽  
Vol 30 (33) ◽  
pp. 4111-4116 ◽  
Author(s):  
Silvia Montoto ◽  
Kate Shaw ◽  
Jessica Okosun ◽  
Shreyans Gandhi ◽  
Paul Fields ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hodgkin Lymphoma ◽  
Highly Active Antiretroviral Therapy ◽  
Prognostic Score ◽  
Complete Response ◽  
Hiv Positive ◽  
Hiv Status ◽  
Non Hodgkin Lymphoma ◽  
Highly Active ◽  
Hiv Negative

Purpose The prognosis of HIV-infected patients with non-Hodgkin lymphoma in the highly active antiretroviral therapy (HAART) era approaches that of the general population when they are treated with the same protocols. We analyzed the outcome of patients with Hodgkin lymphoma (HL) treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in the HAART era according to HIV serostatus to establish whether this also holds true for HL. Patients and Methods From 1997 to 2010, 224 patients newly diagnosed with HL, of whom 93 were HIV positive, were consecutively treated with ABVD chemotherapy. HIV-positive patients had more high-risk disease according to the International Prognostic Score (IPS) than HIV-negative patients (IPS ≥ 3: 68% v 26%, respectively; P < .001). Forty-seven HIV-positive patients had a CD4 count less than 200/μL, and 92 patients received HAART during chemotherapy. Results The complete response rate was 74% for HIV-positive patients and 79% for HIV-negative patients (P = not significant). After a median follow-up of 60 months (range, 8 to 174 months), 23 patients (16 HIV-negative and seven HIV-positive patients) have experienced relapse at a median time of 6 months (range, 1 to 106 months). Five-year event-free survival (EFS) was 59% (95% CI, 47% to 70%) for HIV-positive patients and 66% (95% CI, 57% to 74%) for HIV-negative patients (P = not significant). Five-year overall survival (OS) was 81% (95% CI, 69% to 89%) and 88% (95% CI, 80% to 93%) for HIV-positive and HIV-negative patients, respectively (P = not significant). HIV status did not predict OS or EFS on multivariate analysis including IPS and HIV status. Conclusion This mature study demonstrates that HIV-positive patients with HL have more extensive disease with more adverse prognostic factors than HIV-negative patients, but when treated with ABVD, HIV infection does not adversely affect OS or EFS.

HIV-Specific Differences in Outcome of Squamous Cell Carcinoma of the Anal Canal: A Multicentric Cohort Study of HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy

2008 ◽  
Vol 26 (15) ◽  
pp. 2550-2557 ◽  
Author(s):  
Christoph Oehler-Jänne ◽  
Florence Huguet ◽  
Sawyna Provencher ◽  
Burkhardt Seifert ◽  
Laura Negretti ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Early Stage ◽  
Anal Carcinoma ◽  
Hiv Positive ◽  
Similar Response ◽  
Long Term Outcome ◽  
Highly Active ◽  
Hiv Negative

PurposeTo define clinical outcome after definitive chemoradiotherapy (CRT) of anal carcinoma in HIV-infected patients treated with highly active antiretroviral therapy (HAART).Patients and MethodsA multicentric cohort comparison of 40 HIV-positive patients with HAART and 81 HIV-negative patients treated with radiotherapy (RT) or CRT was retrospectively performed. Local disease control (LC), relapse-free survival (RFS), overall survival (OS), cancer-specific survival (CSS), toxicity, and prognostic factors were investigated.ResultsHIV-positive patients were younger (mean age, 48 v 62 years; P < .0005), predominantly male (93% v 25%; P < .0005), and with early-stage (P = .06) and large-cell histology (90% v 67%; P = .005) disease. RT or CRT resulted in complete response in 92% (HIV positive) and 96% (HIV negative) of cases. Five-year OS was 61% (95% CI, 44% to 78%) in HIV-positive and 65% (95% CI, 53% to 77%) in HIV-negative patients (median follow-up, 36 months). Five-year LC was 38% (95% CI, 5% to 71%) in HIV-positive and 87% (95% CI, 79% to 95%) in HIV-negative patients (P = .008) compromising CSS and sphincter preservation. Grade 3/4 acute skin (35% v 17% [HIV negative]; P = .04) and hematologic (33% v 12% [HIV negative]; P = .08) toxicity together approximated 50% in HIV-positive patients. RFS in HIV-positive patients was associated with RT dose (P = .08) and severe acute skin toxicity (P = .04).ConclusionLong-term LC and acute toxicity represent major clinical challenges in HIV-positive patients with anal carcinoma. Even if fluoropyrimidine-based CRT is feasible and may result in similar response rates and OS as in HIV-negative patients, improved treatment strategies with better long-term outcome are warranted.

scholarly journals Squamous Cell Cancer of the Anal Canal in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy

2010 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nazik Hammad ◽  
Lance K. Heilbrun ◽  
Sachin Gupta ◽  
Nishant Tageja ◽  
Philip A. Philip ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Anal Canal ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Highly Active
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