Steven A Brown1, Salma Abbas, Mary-Ann Davies, Torsak Bunupuradah, Annette H Sohn, Karl-Günter Technau, Lorna Renner, Valériane Leroy, Andrew Edmonds, Marcel Yotebieng, Catherine C McGowan, Stephany N Duda, Lynne Mofenson, Beverly Musick, Kara Wools-Kaloustian. 1. *Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN; †Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA; ‡Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; §HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand; ‖TREAT Asia/amfAR, The Foundation for AIDS Research, Bangkok, Thailand; ¶Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, University of the Witwatersrand, Johannesburg, South Africa; #KorleBu Hospital, Accra, Ghana; **Inserm U1027, University Toulouse 3, Toulouse, France; ††Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC; ‡‡Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH; §§Vanderbilt University School of Medicine, Nashville, TN; ‖‖Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC; and ¶¶Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
Abstract
INTRODUCTION: The incidence and treatment of cancer in HIV-infected children from resource-limited settings has not been extensively studied. OBJECTIVES: Develop and implement a cross-sectional survey to evaluate pediatric cancer burden, diagnostic modalities in use, and treatment availability as perceived by HIV clinic staff at regional International Epidemiology Databases to Evaluate AIDS (IeDEA) sites. METHODS: IeDEA regional investigators developed a cross-sectional clinical site survey which included questions on the numbers and types of pediatric cancers observed, modalities used to treat identified cancers, and treatment options available at individual sites in the Asia-Pacific, Latin America, Central Africa, East Africa, West Africa, and Southern Africa regions. RESULTS: Kaposi sarcoma, non-Hodgkin lymphoma, and Burkitt lymphoma were reported by site personnel to be the most prevalent types of cancer in the pediatric HIV population. Survey results indicate that access to comprehensive cancer treatment modalities is very limited for children in these regions despite HIV care and treatment sites reporting that they diagnose pediatric cancers. Responses also showed that evaluating cancer in the pediatric HIV population is a challenge due to a lack of resources and varying treatment availability within regions. CONCLUSIONS: Further study is needed to increase our understanding of the changing epidemiology of cancer in HIV-infected pediatric populations. Increased financial and technical resources are critical to aid in the advancement of health services to support treatment of these children in resource-constrained settings.
INTRODUCTION: The incidence and treatment of cancer in HIV-infectedchildren from resource-limited settings has not been extensively studied. OBJECTIVES: Develop and implement a cross-sectional survey to evaluate pediatric cancer burden, diagnostic modalities in use, and treatment availability as perceived by HIV clinic staff at regional International Epidemiology Databases to Evaluate AIDS (IeDEA) sites. METHODS: IeDEA regional investigators developed a cross-sectional clinical site survey which included questions on the numbers and types of pediatric cancers observed, modalities used to treat identified cancers, and treatment options available at individual sites in the Asia-Pacific, Latin America, Central Africa, East Africa, West Africa, and Southern Africa regions. RESULTS:Kaposi sarcoma, non-Hodgkin lymphoma, and Burkitt lymphoma were reported by site personnel to be the most prevalent types of cancer in the pediatric HIV population. Survey results indicate that access to comprehensive cancer treatment modalities is very limited for children in these regions despite HIV care and treatment sites reporting that they diagnose pediatric cancers. Responses also showed that evaluating cancer in the pediatric HIV population is a challenge due to a lack of resources and varying treatment availability within regions. CONCLUSIONS: Further study is needed to increase our understanding of the changing epidemiology of cancer in HIV-infected pediatric populations. Increased financial and technical resources are critical to aid in the advancement of health services to support treatment of these children in resource-constrained settings.
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