Prevalence of Cancers Among Patients with HIV Referring to Voluntary Counseling and Testing Center, Tehran, Iran, 2004-2017

Abstract

Background: Malignancies, in part, are responsible for high HIV-related morbidity and mortality. While antiretroviral therapy (ART) substantially decreases the risk of developing AIDS-defining cancers, HIV-infected individuals remain at high risk for non-AIDS-defining cancers. Objectives: In Iran, the epidemiology of AIDS and non-AIDS-defining cancers in the HIV-infected population has not been studied; therefore, this study investigated the prevalence of cancers among HIV-infected patients in Iran. Methods: In this cross-sectional study, using convenient sampling, hospital records of 1243 HIV-infected patients from 2004 to 2017 were collected at the Imam Khomeini Hospital in Tehran. The only inclusion criterion was a positive HIV result of ELISA and Western blot tests. The records were investigated for the occurrence of HIV- and non-HIV-defining cancers. To examine the association between relevant factors and cancer, we used a multivariate logistic regression model to calculate the adjusted Odds Ratio (AOR). Results: Thirty-nine out of 1243 HIV-infected patients, including 16 males (41%) and 23 females (59%), were diagnosed with concurrent cancer (3.1%). Twenty-five individuals had AIDS-defining cancers (2%), and 14 had non-AIDS-defining cancers (1.1%). Cervical cancer was detected in 14 patients (1.1%), non-Hodgkin's lymphoma in 7 patients (0.6%), and Kaposi's sarcoma in 4 patients (0.3%). There was a significant association between age group (30-40 years old) and the type of cancer (P = 0.048). Age group (adjusted odds ratio 3.33 for age group ≥ 50 yrs, 95% CI: 0.42-26.60) and gender (adjusted odds ratio 0.36 for men, 95% CI: 0.18–0.70) remained independently associated with cancer (P < 0.05). Conclusions: The prevalence of AIDS-defining cancers was higher than non-AIDS-defining cancers. These results highlighted the importance of promoting cancer screening and early ART initiation among HIV-infected patients.