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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] T Powles1, G Daugaard2, MR Nelson1, T Oliver3, M Fisher4, J Stebbing5, J Anderson3, M Johnson5, BG Gazzard1 and M Bower1
1 Chelsea & Westminster Hospital, London, UK, 2 Rigshospitalet, Copenhagen, Denmark, and 3 St Bartholomew's, 4 Royal Sussex County and 5 Royal Free Hospitals, London, UK
BHIVA Conf 2002 Apr 19-21;8:O25
INTRODUCTION: We present a large multicentre series addressing the clinical presentation, therapy and prognosis of HIV-related germ-cell tumours (GCT) and their treatment.
METHODS: During 1984–1999, 31 HIV-positive men presented with GCT to four UK and one Danish HIV treatment centres. The median age was 33.7 years (range 23-61) and CD4 count 275 cells/µL (90-922) at diagnosis. The median duration of HIV infection prior to diagnosis of GCT was 42 months (0–108).
RESULTS: 78% were diagnosed with seminoma and 22% with mixed GCT. Treatment comprised surveillance or adjuvant therapy for stage I disease, chemotherapy (CT) or radiotherapy (RT) for stage II and CT for stage III. Ten patients received CT, five RT and one had both, without excessive adverse effects. Treatment caused in fall in the median CD4 count (283–200 cells/µL). Four patients received highly active antiretroviral therapy before GCT diagnosis, and 14 started subsequently.
| Prior | CD4 count | Follow-up | HIV | GCT | |||
| Stage | n | AIDS | (cells/µL)* | (months [range]) | deaths | deaths | |
| I | 21 | 38% | 275 | 52 (90–118) | 28% | 4% | |
| II | 6 | 16% | 190 | 54 (6–96) | 33% | 16% | |
| III | 4 | 0% | 320 | 68 (12–115) | 25% | 0% |
*At diagnosis of GCT
DISCUSSION: The excess of seminoma supports the findings of large US cohort studies; other series from Europe have suggested an excess of mixed GCT and teratomas. The GCTs in this series present and should be treated as in the HIV-negative population. Chemotherapy and radiotherapy are well tolerated, but adversely affect the CD4 count.
PRESENTING AUTHOR: T Powles
020419
O25
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD