AEGiS-13IAC: Cancer in American children with AIDS.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Cancer in American children with AIDS.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrB114)

Biggar R, Frisch M, Goedert J
R. Biggar, National Cancer Institute, 6120 Executive Boulevard, EPS/8003, MSC 7248, Rockville, MD 20852, United States, Tel.: +1 301 496 81 15, Fax: +1 301 402 08 17, E-mail: biggarb@exchange.nih.gov

BACKGROUND: Most studies of cancers associated with AIDS in children are based on case series, which may be biased by referral. We examined population-based records to determine the risk of pediatric AIDS-associated cancers.

METHODS: Using records from 11 locations in the United States, we linked records of children with AIDS-defining diseases between 0 and 14 years old to local cancer registry data. Cancer incidence and relative risk was assessed within demographic groups and children infected by different HIV-infection routes.

RESULTS: Among 4,954 children with AIDS, 124 (2.5%) had cancer, including 100 (81%) non-Hodgkin's lymphomas (NHLs), 8 (6%) Kaposi's sarcomas (KS), 4 (3%) leiomyosarcomas, 2 (2%) Hodgkin's diseases, and 10 (8%) other or unspecified cancers. In the first two years after AIDS (5,485 person-years), the relative risk (RR) of NHL was 651 (95% confidence interval 432-841). Two thirds of the NHLs were diagnosed at AIDS onset. The commonest NHL type was Burkitt's lymphoma. However, primary brain lymphomas were frequent (RR 7,143) and often occurred in long-term survivors. Leiomyosarcomas often occurred several years after AIDS; the RR in the 2-5 year post-AIDS period was 1,915. KS was reported only at or within two years of AIDS diagnosis. Hodgkin's disease risk (RR 61.5) was also significantly increased. No other specified tumors were linked to AIDS in children.

CONCLUSIONS: The types of AIDS-associated pediatric cancers resemble those seen in adults, with the addition of leiomyosarcoma. Both primary brain lymphomas and leiomyosarcomas tended to occur in long-term AIDS survivors.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Neoplasms, Sarcoma, Kaposi, Incidence, HIV Infections, Lymphoma, Non-Hodgkin, Risk Factors, Registries, Hodgkin Disease, Ethnic Groups, Leiomyosarcoma, African Americans, United States, Case-Control Studies, Child, Human, Adult
000709
MoOrB114