ABSTRACT
BACKGROUND: The goal was to assess the survival of HIV+ women and HIV- women for breast cancer at a referral center for cancer treatment in Brazil. METHODS: A retrospective cohort study was performed. A total of 136 women patients with breast cancer were included, being 36 HIV+ women and 100 HIV- women. Controls (HIV-) were selected according to HIV status, matched by date of cancer diagnosis, clinical stage, breast cancer treatment, and date of birth. Sociodemographic and cancer treatment data, as well as clinical HIV data, were extracted from physical and electronic medical records and secondary Instituto Nacional of cancer databases. To estimate survival, the Kaplan-Meier method was used. To determine the factors associated with mortality, Cox regression were used. RESULTS: The mean age of patients at diagnosis of cancer was 52 years. Regarding marital status, HIV+ patients had a higher frequency of single status). There were 44.1% deaths that occurred during the study period. Among HIV+ patients, there were 16 deaths, 15 of which were due to cancer. In HIV- patients there were 44 deaths (44%), with 32 cancer as the cause of death and 12 due to other causes. For the analysis of Overall. Differences were found in overall survival at 60 months (p=0.026), 55% and 69% respectively. The increased risk of death at 60 months among HIV+ women was observed also, after adjusting for schooling and molecular subtype (HR=1.95; 95% CI 1.03 - 3.70; p=0.041). CONCLUSION: HIV infection influenced a worse prognosis for women with breast cancer regardless of tumor factors.
Subject(s)
Breast Neoplasms , HIV Infections , Brazil/epidemiology , Breast Neoplasms/complications , Breast Neoplasms/therapy , Cohort Studies , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Middle Aged , National Cancer Institute (U.S.) , Retrospective Studies , United StatesABSTRACT
infecção pelo vírus da imunodeficiência humana (HIV) aumenta significativamente o risco de desenvolver alguns tipos de câncer, incluindo o câncer cervical. O câncer de colo de útero (CCU) é uma causa importante de morbi-mortalidade em mulheres HIV+. Com a introdução do tratamento antirretroviral e o aumento da expectativa de vida de pessoas vivendo com HIV, muitas mulheres HIV+ diagnosticadas com CCU não morrerão de Aids, o que torna importante a compreensão do impacto do HIV no prognóstico de câncer em pacientes que receberam tratamento para o mesmo. O objetivo do estudo foi avaliar a influência da infecção pelo HIV no prognóstico de mulheres com CCU matriculadas e tratadas no INCA no período de 2001-2013. Metodologia: Para isso foi realizado primeiramente um estudo descritivo da população de mulheres com CCU matriculadas no INCA, utilizando a base de dados clínicos do INCA. Depois de identificadas as pacientes HIV+ através dos dados fornecidos pela tecnologia da informação, as mesmas foram pareadas a partir da população de pacientes testadas para HIV no INCA. Para cada mulher HIV+ foram selecionadas até quatro mulheres com CCU HIV- (1:4). O grupo de comparação foi pareado de acordo com o tipo histológico, estadiamento clínico, tratamento realizado, ano da matrícula e idade. Para a população final do estudo foram coletados dados sócio-demográficos, clínicos e tratamento de câncer no prontuário físico. Os dados sobre a infecção do HIV tais como contagem de CD4 e carga viral ausentes no prontuário, foram fornecidos pelo SISCEL. Foi realizado o teste Q-quadrado para comparação dos grupos, Kaplan-Meier para as análises de sobrevida e o modelo regressão de Cox para as análises de risco...
Infection with the human immunodeficiency virus (HIV) significantly increases the risk ofdeveloping certain types of cancer, including cervical cancer. Cervical cancer is a major cause of morbidity and mortality in HIV+ women. With the introduction of antiretroviral treatmentand increasing life expectancy of people living with HIV, many HIV+ women diagnosed with cervical cancer do not die from AIDS, which makes it important to understand the impact ofHIV on cancer prognosis in patients treated for the disease. The aim of the study was to evaluate the influence of HIV infection on the prognosis of women with cervical cancer enrolled and treated in INCA in the 2001-2013 period. Methodology: This was a descriptive study of the population of women with cervical cancer enrolled in INCA using the Institution´s database . After identifying the HIV+ patients through the data provided by theIinformation Technology sector, women were paired from the patient population tested for HIV at INCA. For each HIV+ woman, up to four HIV- women with cervical cancer were randomly selected . The comparison group was matched according to the histological type,clinical stage, treatment performed, year of registration and age. For the study, we collected socio demographic, clinical and cancer treatment data from medical records. Data on HIV infection such as CD4+ T-cell counts and HIV viral load missing in medical records, were retrieved from the SISCEL database. Chi-square tests were performed to compare the groups,Kaplan-Meier methods for survival analysis and Cox regression models for risk analysis. Results: Our results showed that between 2001 and 2013 8,744 women with cervical cancerwere enrolled in the institution; of those, 5,475 were tested for HIV and 91 were HIVpositive...
