scholarly journals Cancer risk among adolescents and young adults living with HIV in South Africa: a national cohort study

2021 ◽  
Author(s):  
Yann Ruffieux ◽  
Tafadzwa Dhokotera ◽  
Mazvita Muchengeti ◽  
Lina Bartels ◽  
Victor Olago ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Young Adults ◽  
Hodgkin Lymphoma ◽  
Kaposi Sarcoma ◽  
Adolescents And Young Adults ◽  
Age Group ◽  
Non Hodgkin Lymphoma ◽  
Living With Hiv ◽  
Cd4 Cell

Background: We studied the incidence of and risk factors for various types of cancers in adolescents and young adults living with HIV (AYALWH) in South Africa between 2004 and 2014. Methods: We included individuals aged 15 to 24 years from the South African HIV Cancer Match study, a large cohort resulting from a linkage between HIV-related laboratory measurements from the National Health Laboratory Services and records from the National Cancer Registry. We computed incidence rates for the most common cancers. We assessed associations between these cancers and sex, age, calendar year, and CD4 cell count using Cox models and adjusted hazard ratios (aHR).Findings: We included 782,454 AYALWH (89% female). Of those, 867 developed incident cancer including 429 who developed Kaposi sarcoma, 107 non-Hodgkin lymphoma, 48 Hodgkin lymphoma, 45 cervical cancer, and 32 leukaemia. Kaposi sarcoma was more common in the 20-24 year age group than the 15-19 year age group (aHR 1.39, 95% CI 1.03-1.86). Male sex was associated with higher rates of Kaposi sarcoma (aHR 2.06, 95% CI 1.61-2.63), non-Hodgkin lymphoma (aHR 3.17, 95% CI 2.06-4.89), Hodgkin lymphoma (aHR 4.83, 95% 2.61-8.93), and leukaemia (aHR 5.90, 95% CI 2.87-12.1). Lower CD4 cell counts at baseline were associated with higher rates of Kaposi sarcoma, cervical cancer, non-Hodgkin and Hodgkin lymphoma.Interpretation: Infection-related cancers are the most common cancer types among AYALWH in South Africa. The burden of these cancers may be reduced through HPV vaccination, targeted HIV testing, early initiation of antiretroviral therapy, and improvement of treatment adherence.

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e043941
Author(s):  
Tafadzwa Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ronnie Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Cross Sectional Study ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Laboratory Service ◽  
Living With Hiv

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry (NCR) and HIV records from the National Health Laboratory Service (NHLS).Setting and participantsThe NHLS is the largest provider of pathology services in the South African public sector. The NCR is a division of the NHLS. We included AYAs (aged 10–24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8479). HIV status was obtained through record linkages and text mining.Primary and secondary outcomesWe determined the spectrum of cancers by HIV status in AYAs. We used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex, ethnicity and calendar period. We imputed (post hoc) the HIV status for AYA with unknown HIV status.Results8479 AYAs were diagnosed with cancer, HIV status was known for 45% (n=3812). Of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi’s sarcoma (adjusted OR (aOR) 218, 95% CI 89.9 to 530), cervical cancer (aOR 2.18, 95% CI 1.23 to 3.89), non-Hodgkin’s lymphoma (aOR 2.12, 95% CI 1.69 to 2.66) and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27 to 5.86) than AYAs without HIV. About 44% (n=1062) of AYAs with HIV-related cancers had not been tested for HIV.ConclusionsTargeted HIV testing for AYAs diagnosed with cancer, followed by immediate start of antiretroviral therapy, screening for cervical precancer and vaccination against human papilloma virus is needed to decrease cancer burden in AYAs living with HIV in South Africa.

HIV associated cancers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18254-e18254
Author(s):  
Prabhjot Singh Bedi ◽  
Manoj P. Rai ◽  
Fawzi Abu Rous ◽  
Rohanlal Vishwanth ◽  
Nishraj Basnet ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Head And Neck Cancer ◽  
Skin Cancer ◽  
Head And Neck ◽  
Hodgkin Lymphoma ◽  
Anal Cancer ◽  
Kaposi Sarcoma ◽  
P Value ◽  
Non Hodgkin Lymphoma

e18254 Background: The incidence or the prevalence of AIDS-defining cancers has reduced drastically (70% or more in the United States) since the introduction of three-drug antiretroviral therapy (ART) in the mid-1990s. However, the data from the inpatient sample is lacking. Methods: This is a retrospective analysis using data from the 2014 National Inpatient Sample database. We identified patients with either primary or secondary diagnosis of human immunodeficiency virus (HIV). Then we identified patients with various cancers including AIDS-defining cancers. Afterward, we ran logistic regression to check the degree of association between the diagnosis of each cancer with the diagnosis of HIV during the identified hospitalizations. We also assessed the prevalence of each of the cancer among the identified HIV patients, as well as the mortality in this cohort. Results: A total of 115955 hospitalizations with a diagnosis of HIV were identified. Among them, there were 6985 hospitalizations with Non-Hodgkin lymphoma, 2230 with rectal and anal cancer, 1170 with Kaposi sarcoma, 870 with head and neck cancer, 865 with skin cancer, 840 with cervical cancer. Logistic regression showed odds ratio (OR) of 1632.857 (95% CI 1168 - 2284, p < 0.01) for Kaposi sarcoma, 9.13 (95% CI 5.7-14.5, p-value < 0.01) for other male cancer, 8.34 (95% CI 7.68-9.06; p-value < 0.01) for Non-Hodgkin's lymphoma, 6.65 (95% CI was 5.5-8, p-value < 0.01) for Hodgkin's lymphoma, 5.04 (95% CI 4.5-5.6 p < 0.01) for rectal and anal cancer, 2.33 (95% CI 1.9-2.8, p < 0.01) for cervical cancer. Mortality was statistically significant with liver cancer, lung cancer, brain cancer, Hodgkin lymphoma, and Kaposi sarcoma. Conclusions: The prevalence of Kaposi sarcoma, Non-Hodgkin lymphoma, and cervical cancer are found to be high among hospitalized patients with HIV most likely because of nonadherence to their HIV medications. Future studies to check their correlation of these cancers with disease control is required. It is interesting to note that the prevalence of rectal and anal cancer, head and neck cancer, and skin cancer is high in this cohort.

scholarly journals US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma

2015 ◽  
Vol 26 (8) ◽  
pp. 1153-1162 ◽  
Author(s):  
Erin E. Kent ◽  
Nancy Breen ◽  
Denise R. Lewis ◽  
Janet S. de Moor ◽  
Ashley Wilder Smith ◽  
...  
Keyword(s):  
Young Adults ◽  
Hodgkin Lymphoma ◽  
Adolescents And Young Adults ◽  
Non Hodgkin Lymphoma

Malignant hematologic diseases in adolescents and young adults

Blood ◽  
2011 ◽  
Vol 117 (22) ◽  
pp. 5803-5815 ◽  
Author(s):  
William A. Wood ◽  
Stephanie J. Lee
Keyword(s):  
Young Adults ◽  
Hodgkin Lymphoma ◽  
Care Delivery ◽  
Health Care Systems ◽  
Lymphoblastic Leukemia ◽  
Hematologic Malignancies ◽  
Adolescents And Young Adults ◽  
Adult Health ◽  
Non Hodgkin Lymphoma ◽  
Care Systems

Abstract Adolescents and young adults (AYA) with cancer have been designated as a vulnerable population by the National Cancer Institute. This group, defined by the ages of 16-39 years, has not enjoyed the same survival improvements over the past several decades as older and younger cohorts. Several barriers prevent the optimal delivery of oncologic care in this subpopulation. This review will describe these challenges in the context of the major hematologic malignancies affecting this population (acute lymphoblastic leukemia [ALL], acute myeloid leukemia [AML], Hodgkin lymphoma [HL], and non-Hodgkin lymphoma [NHL]). For example, historical differences in care delivery between pediatric and adult health care systems have created confusion about optimal treatment planning for AYAs, a population that spans the pediatric-adult divide. In the case of ALL, retrospective studies have demonstrated significantly better outcomes when AYAs are treated according to pediatric and not adult protocols. Additional challenges more specific to AYAs include increased treatment-related toxicity relative to younger patients; less access to care and, specifically, access to clinical trials; lower adherence to medications and treatment plans; and psychosocial stressors relevant to individuals at this stage of life. Recognizing and responding to these challenges in AYAs may create opportunities to improve the cancer outcomes of this group.

scholarly journals 940. Impact of Using Arts Programming to Support Treatment in Adolescents Living with HIV in Eswatini

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S503-S503
Author(s):  
Vedika Agrawal ◽  
Tara Ness ◽  
Amanda Small ◽  
Tandzile T Simelane ◽  
Bhekemusa Lukhele ◽  
...  
Keyword(s):  
Young Adults ◽  
Medication Adherence ◽  
Sense Of Community ◽  
Community Building ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
Creative Arts ◽  
Age Group ◽  
Personal Stigma ◽  
Living With Hiv

Abstract Background Adolescents and young adults with HIV are a unique population given the distinct psychosocial challenges of their age-group coupled with having a stigmatizing disease. In 2018, approximately 1.6 million adolescents were living with HIV worldwide, with the highest HIV prevalence found in Eswatini. As this group struggles more than any other age-group with medication adherence, novel interventions that are peer-inclusive and empowering should be explored to support their treatment. Methods We piloted a theater camp to determine the impact of fostering creative expression amongst adolescents and young adults enrolled at our HIV clinic in Mbabane, Eswatini. A two-week camp was conducted in collaboration with a non-profit organization of professional teachers, actors, and musicians. We emphasized enrollment of patients struggling with medication adherence, teen mothers, and those on second-line antiretroviral treatment. Twenty individuals (ages 12-23) participated in self-expression activities, story development, and a final play performed for the community. To assess impact, we compared viral loads pre- and post- camp as well as surveyed participants on effect of participation on areas such as personal stigma, sense of community, and confidence. Results Of those who participated, 25% showed a substantial decrease and 10% a substantial increase in viral load after the camp (&gt;0.1 log10 change). Those who completed the survey (n=18) felt the camp helped them with confidence (13/18), teamwork (13/18), and friendships (11/18). Quotes from participants reinforced this growing sense of community, confidence, and decreased personal stigma. One wrote “theater camp helped me know that I can do a lot of things in life to achieve my future goals although I am HIV positive” and another stated “it made me not feel sorry for being an HIV positive person.” Conclusion Our pilot program demonstrates creative arts programming has beneficial psychosocial effects, aids in community building, and potentially enhances the effectiveness of medical treatment. Further programs and studies should continue to investigate creative arts as an avenue for treatment support, self-expression, and community building among vulnerable populations such as adolescents and young adults with HIV. Disclosures All Authors: No reported disclosures

Cancer risk in adolescents and young adults living with HIV in South Africa: a nationwide cohort study

2021 ◽  
Author(s):  
Yann Ruffieux ◽  
Tafadzwa Dhokotera ◽  
Mazvita Muchengeti ◽  
Lina Bartels ◽  
Victor Olago ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Cohort Study ◽  
Cancer Risk ◽  
Adolescents And Young Adults ◽  
Living With Hiv
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