OBJECTIVES: To determine the incidence of and factors associated with malignancy in perinatally human immunodeficiency virus (HIV)-infected children in the United States. METHODS: Included were 2969 children followed in the Pediatric AIDS Clinical Trials Group (PACTG) 219/219C cohort from 1993 through 2003. Cancer incidence by sex, race, age, histology and highly active antiretroviral therapy (HAART) era (pre-HAART, 1993-1997; HAART, 1998-2003) was estimated, and the standardized incidence ratio contrasting infected and uninfected children was determined. Poisson regression was used to further investigate the relation between HAART use (> or =3 drugs of > or =2 classes, 1 of which was a protease inhibitor), CD4% and cancer. RESULTS: There were 37 cancers (17 prevalent and 20 incident) diagnosed in 2969 children for a prevalence of 0.6% [95% confidence interval (CI), 0.3, 0.9] and an incidence of 1.56/1000 person-years (95% CI 0.95, 2.41). Compared with uninfected children, the standardized incidence ratio was 10.08 (95% CI 5.87, 16.14). Incidence did not significantly differ by sex, race, age or HAART era. Of the cases, 35% were immunocompetent (CD4 > or =25%), 25% were moderately immunosuppressed (15%< or = CD4 < or =24%) and 40% were severely immunosuppressed (CD4 <15%) at diagnosis. In multivariate regression, the cancer rate was 3.09 (95% CI 1.22, 7.85) times higher in children with < or =2 years of HAART use than in children with >2 years of HAART and 3.20 (95% CI 1.32, 7.76) times higher in children with CD4 <15% at cohort enrollment than in children with CD4 > or =15%. CONCLUSION: Cancer incidence in this U.S. pediatric cohort was lower than that of European cohorts but was markedly higher than that of HIV-uninfected children. Cancer incidence was highest in children who were severely immunosuppressed and in children who received HAART for < or =2 years.
OBJECTIVES: To determine the incidence of and factors associated with malignancy in perinatally human immunodeficiency virus (HIV)-infectedchildren in the United States. METHODS: Included were 2969 children followed in the Pediatric AIDS Clinical Trials Group (PACTG) 219/219C cohort from 1993 through 2003. Cancer incidence by sex, race, age, histology and highly active antiretroviral therapy (HAART) era (pre-HAART, 1993-1997; HAART, 1998-2003) was estimated, and the standardized incidence ratio contrasting infected and uninfected children was determined. Poisson regression was used to further investigate the relation between HAART use (> or =3 drugs of > or =2 classes, 1 of which was a protease inhibitor), CD4% and cancer. RESULTS: There were 37 cancers (17 prevalent and 20 incident) diagnosed in 2969 children for a prevalence of 0.6% [95% confidence interval (CI), 0.3, 0.9] and an incidence of 1.56/1000 person-years (95% CI 0.95, 2.41). Compared with uninfected children, the standardized incidence ratio was 10.08 (95% CI 5.87, 16.14). Incidence did not significantly differ by sex, race, age or HAART era. Of the cases, 35% were immunocompetent (CD4 > or =25%), 25% were moderately immunosuppressed (15%< or = CD4 < or =24%) and 40% were severely immunosuppressed (CD4 <15%) at diagnosis. In multivariate regression, the cancer rate was 3.09 (95% CI 1.22, 7.85) times higher in children with < or =2 years of HAART use than in children with >2 years of HAART and 3.20 (95% CI 1.32, 7.76) times higher in children with CD4 <15% at cohort enrollment than in children with CD4 > or =15%. CONCLUSION:Cancer incidence in this U.S. pediatric cohort was lower than that of European cohorts but was markedly higher than that of HIV-uninfectedchildren. Cancer incidence was highest in children who were severely immunosuppressed and in children who received HAART for < or =2 years.
Authors: Nader Kim El-Mallawany; William Kamiyango; Jeremy S Slone; Jimmy Villiera; Carrie L Kovarik; Carrie M Cox; Dirk P Dittmer; Saeed Ahmed; Gordon E Schutze; Michael E Scheurer; Peter N Kazembe; Parth S Mehta Journal: PLoS One Date: 2016-04-15 Impact factor: 3.240
Authors: Nader Kim El-Mallawany; Mercy Mutai; Idah Mtete; Satish Gopal; Christopher C Stanley; Peter Wasswa; Mary Mtunda; Mary Chasela; William Kamiyango; Jimmy Villiera; Yuri Fedoriw; Nathan D Montgomery; George N Liomba; Coxcilly Kampani; Robert Krysiak; Katherine D Westmoreland; Maria H Kim; Jeremy S Slone; Michael E Scheurer; Carl E Allen; Parth S Mehta; Peter N Kazembe Journal: Glob Pediatr Health Date: 2017-06-23
Authors: Lorena Vigón; Paula Martínez-Román; Sara Rodríguez-Mora; Montserrat Torres; María C Puertas; Elena Mateos; María Salgado; Antonio Navarro; Matilde Sánchez-Conde; Juan Ambrosioni; Miguel Cervero; Christoph Wyen; Christian Hoffmann; José M Miró; José Alcamí; Daniel Podzamczer; Valentín García-Gutiérrez; Javier Martínez-Picado; Verónica Briz; María Rosa López-Huertas; Vicente Planelles; Mayte Coiras Journal: Biochem Pharmacol Date: 2021-06-26 Impact factor: 6.100