Changing trends in the incidence and spectrum of cancers between 1990 and 2021 among HIV-infected patients in Busan, Korea.

BACKGROUND: Long-term follow-up data on cancer incidence and spectrum among human immunodeficiency virus (HIV)-infected individuals in Korea have been scarce. MATERIAL AND METHODS: This retrospective cohort study included HIV-infected individuals visiting a tertiary care hospital in Busan, South Korea between 1990 and 2021. The observation was divided into 4 periods. The incidence rate was calculated using direct standardization on age and sex, stratified by calendar period. RESULTS: Of the 1,297 patients, 92 patients (7.1%) were diagnosed with 97 cancers. Excluding 37 patients with prevalent cancer, 1,260 patients were followed for a total of 8,803.7 person-years (PYs), and 55 patients developed 60 incident cancers including 5 second primary incident cancers. In men, the AIDS-defining cancer (ADC) incidence decreased from 294.7 per 100,000 PYs in 1990-1997 to 124.8 per 100,000 PYs in 2014-2021, while the non-AIDS-defining cancer (NADC) incidence increased from 0 per 100,000 PYs to 316.5 per 100,000 PYs during the same period. The proportion of virus-unrelated NADCs (VU-NADCs) increased from 33.3% in 1998-2005 to 49% in 2014-2021. The proportion of human papillomavirus-associated cancers (HPVACs) has recently increased in both ADCs and NADCs. The median time from HIV diagnosis to their first cancer was 1.48 years for ADCs, 6.11 years for VR-NADCs, 8.3 years for VU-NADCs, and 11.5 years for HPVACs. CONCLUSION: The incidence of NADCs is increasing with the aging of HIV-infected patients, and thus, it is necessary to promote cancer screening and prevention programs.

Ten-Year Trends of Hepatitis A Seroprevalence in People Living with HIV in Korea.

Epidemiological information on hepatitis A among people living with HIV (PLHIV) in Korea is scarce. This retrospective study was performed at a tertiary care hospital and included 756 PLHIV with anti- hepatitis A virus (HAV) IgG tests. Between 2012 and 2021, the age at anti-HAV IgG seroconversion is gradually delayed, and the proportion of individuals susceptible to HAV infection increased among adult PLHIV in Korea. The independent risk factors for HAV seropositivity were female sex and HBs antigen (Ag) positivity. Therefore, HAV vaccination is highly recommended for young PLHIV, especially for women or HBsAg-positive individuals.

Seroprevalence of Helicobacter pylori in human immunodeficiency virus-infected patients in a tertiary care hospital in Busan, South Korea.

INTRODUCTION: Human immunodeficiency virus (HIV) infection management has recently become more successful. While the life expectancy of HIV-infected patients increased, the prevalence of non-acquired immunodeficiency syndrome-defining cancers, such as gastric cancer, also increased. Helicobacter pylori is associated with gastric cancer, the most common cancer and the fourth leading cause of cancer-related deaths in South Korea, which has the highest incidence of chronic gastric mucosa inflammation. Here, the seroprevalence and risk factors of H. pylori infection in Korean HIV-infected patients were evaluated. METHODS: Three hundred HIV-infected patients attending the Outpatient Department of Pusan National University Hospital were prospectively enrolled from October 2018 to February 2019. Socio-demographic information was evaluated using questionnaires, and the serological status of H. pylori infection was analyzed for anti-H. pylori IgG antibodies. RESULTS: The overall seropositivity of H. pylori was 32.7%, and 254 patients (84.7%) were male. The risk factors significantly associated with H. pylori seropositivity were: age of 40-49 years (odds ratio [OR] = 5.00; 95% confidence interval [CI] 1.30-19.17), age of 50-59 years (OR = 3.93; 95% CI 1.05-14.73), CD4 cell counts of 350-500/µL (OR = 4.23; 95% CI 1.53-11.65), CD4 cell counts ≥500/µL (OR = 2.78; 95% CI 1.15-6.72), and a weekly average alcohol consumption of at least one alcoholic beverage (OR = 1.78; 95% CI 1.05-2.99). CONCLUSIONS: The seroprevalence of H. pylori is significantly associated with alcohol consumption, high CD4 cell count, and the age group of 40-59 years.

Influence of Vitamin D Deficiency on the Development of Opportunistic Infection in People Living with HIV/AIDS (PWHAs).

BACKGROUND: It is known that vitamin D is associated with immune cell growth, and an association between vitamin D deficiency and development of chronic infections such as tuberculosis has been reported. However, there have been few studies concerning the association between vitamin D deficiency and opportunistic infection (OI) in people living with HIV/AIDS (PWHA). METHOD: PWHAs who had vitamin D (25-OH vitamin D, 25OHD) test results from 2012 to 2017 were enrolled. All enrolled PWHAs were divided into a vitamin D-deficient group and non-deficient group according to the 25OHD cutoff set by ROC curve analysis. The rates of OIs were compared between the two groups. RESULTS: Among 440 enrolled PWHAs, 394 (89.5%) were male, 32 were ≥ 65 years (13.4%), 237 (53.9%) were ART-naïve, and 107 (24.3%) had CD4 + T cell < 200/L. Seventy-three cases of OIs occurred in 63 PWHAs (14.3%); the most common OI was tuberculosis (27, 6.1%) followed by pneumocystis pneumonia (PCP) (25, 5.7%), and Cytomegalovirus (CMV) diseases (10, 2.3%). In the ROC curve analysis, the AUC was 0.71 (95% CI 0.64- 0.79, P < 0.001) and the optimal cutoffs of 25OHD to predict OIs was 14 ng/mL.Overall OI development was significantly more prevalent in the vitamin D-deficiency group (aOR 3.05, 95% CI 1.43-6.48); tuberculosis (aOR 3.51, 95% CI 1.22-10.05) and CMV disease (aOR 10.13, 95% CI 1.11-92.03) were significantly associated with vitamin D deficiency, whereas PCP was not (aOR 1.32, 95% CI 0.44-3.98). CONCLUSION: Stringent cutoffs of vitamin D deficiency (< 14 ng/mL) were well correlated with development of OIs in PWHAs. Vitamin D deficiency was associated with development of OIs, particularly tuberculosis and CMV infections.