[O-23] AIDS and non-AIDS defining malignancies in HIV-infected patients: the 2006 ONCOVIH French study

10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV

6-8 November 2008, London, UK

AIDS AND NON-AIDS DEFINING MALIGNANCIES IN HIV-INFECTED PATIENTS: THE 2006 ONCOVIH FRENCH STUDY

Antiviral Therapy 2008; 13(Suppl. 4):A17 (abstract no. O-23)

E Lanoy¹, JP Spano², F Bonnet³, F Boué⁴, J Cadranel⁵, G Carcelain², LJ Couderc⁶, P Frange⁷, PM Girard⁸, E Oksenhendler⁹, I Poizot-Martin¹⁰, C Semaille¹¹, H Agut², C Katlama^1,2 and D Costagliola^1,2
¹INSERM U720, Paris, France; ²UPMC Univ Paris 06, Groupe hospitalier Pitié-Salpêtrière, Paris, France; ³CHU de Bordeaux, Hôpital Saint-André; INSERM U897; Université Victor Segalen, Bordeaux, France; ⁴Hôpital Antoine Béclère, Clamart, France; ⁵Hôpital Tenon, Paris, France; ⁶Hôpital Foch, Suresnes, France; ⁷Hôpital Necker-Enfants Malades, Paris, France; ⁸Hôpital Saint- Antoine, Paris, France; ⁹Hôpital Saint-Louis, Paris, France; ¹⁰Hôpital Sainte-Marguerite, Marseille, France; ¹¹Institut de Veille Sanitaire, Saint Maurice, France

OBJECTIVES: The aim of the ONCOVIH study was to describe the distribution of malignancies in HIV-infected patients in France and the 1-year prognosis following this diagnosis.

METHODS: ONCOVIH was a national cross-sectional study with a prospective reporting of all new cases of malignancies diagnosed in HIV-infected patients in 2006 in over 300 care centres involved in the management of patients with HIV and/or malignancies. Characteristics of HIV infection and malignancies, occurrence and cause of death were collected using a standardized questionnaire at the diagnosis of malignancy and every 3 months during 1 year. Histological results and causes of death were reviewed by a panel of clinicians and epidemiologists. Data from HIV patients followed in hospital in France in 2006 were extracted from ANRS CO4-FHDH.

RESULTS: Overall, 116 clinical centres reported 694 new malignancies in 690 patients, of whom 669 patients (533 men and 136 women) were evaluable (Table 1). Most common malignancies were NHL (n=145, 21.5%), Kaposi’s sarcoma (n=107, 15.9%), lung cancer (n=63, 9.4%), anal cancer (n=55, 8.2%), Hodgkin’s lymphoma (n=51, 7.6%), cutaneous non-melanoma (n=46, 6.8%) and liver cancers (n=38, 5.6%). Cervix cancer was diagnosed in 10 women.

Table 1. Characteristics (at diagnosis for ONCOVIH or in 2006 for FHDH) of patients (Abstract O-23)
	All patients	AIDS-defining malignancies	Non-AIDS-defining malignancies	ANRS CO4-FHDH 2006
Total	669	258	411	–
Proportion of women, %	20	19	21	33
Median age, years (interquartile range)	47 (41–55)	44 (38–51)	49 (42–57)	43 (37–49)
Proportion of patients diagnosed with HIV infection <6 month previously, %	14	28	5	5
Median nadir CD4+ T-cell count, cells/mm³ (interquartile range)	144 (49–260)	134 (44–263)	147 (52–259)	193 (86–307)
CD4+ T-cell count, cells/mm³ (interquartile range)	275 (144–446)	193 (67–357)	329 (193–500)	454 (312–634)
Proportion of patients receiving ART and with plasma HIV RNA <500 copies/ml, %	47	23	61	67
With 185 deaths, the overall 1-year survival rate was 72% (95% confidence interval 68–75) and much lower after a diagnosis of lung cancer (35%), hepatocarcinoma (47%) or NHL (65%).

CONCLUSION: In 2006, almost two thirds of diagnosed malignancies in HIV-infected patients were non-AIDS defining. Malignancies were diagnosed in patients with a lower CD4+ T-cell count than the whole population of HIV-infected patients, even for non-AIDS malignancies. Patients with AIDS malignancies also more often had detectable plasma HIV RNA. This suggests that a better control of HIV and its associated immunodeficiency is required to prevent malignancies in HIV-infected patients.

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2008-11-06
O-23

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