Evaluation of the prevalence of malignancy in patients diagnosed with HIV/AIDS in our clinic between 2011-2021

Effective ART use in HIV-infected patients has led to increased life expectancy and the emergence of additional comorbidities. HIV's own pro-oncogenic effect, coexisting viral infections such as HBV, HCV, EBV, HPV, increased tobacco and alcohol use in patients are effective in malignancy incidence. The aim of this study was to determine the incidence of AIDS-defining cancers and non-AIDS-defining cancers, to investigate the risk factors involved, and to ensure the effective and accurate implementation of cancer screening programs in light of the data obtained. Patients diagnosed with HIV/AIDS at the Department of Infectious Diseases and Clinical Microbiology of Akdeniz University between 2011 and 2021 were included in the study with the approval of the ethics committee numbered 70904504151. Demographic, clinical, laboratory data and department file records of the patients were obtained. In this study, cancer was detected in 25 of 433 patients. Of these, 12 cases occured at the time of HIV diagnosis, while the other 13 cancers developed during patient follow-ups. The mean age of the patients at the time of cancer diagnosis was 50.3 ± 13, while there were 17 cancer patients with CD4 T lymphocyte count below 200 cells/µl at the time of diagnosis. There was a significant difference between cancer development and advanced age of the patients, low CD4 T lymphocyte count at the time of diagnosis, high viral load at the time of diagnosis, and exposure to infections during follow-up. Of the total 25 malignancies, 12 (48.0%) were AIDS-defining cancers, while 13 (52.0%) were non-AIDS-defining cancers. Kaposi's sarcoma, seen in 9 patients, ranked first among AIDS-defining cancers, while Hodgkin's lymphoma, seen in 4 patients, ranked first among non-AIDS-defining cancers. The rate of AIDS-defining cancer was higher in patients with CD4 T lymphocyte count < 200 cells/µl at the time of malignancy diagnosis, HIV diagnosis and malignancy diagnosis were simultaneous, and coexisting infection during follow-up. A total of 6 people who were diagnosed with cancer died during follow-up, 3 of them had AIDS-defining cancer and 3 had non-AIDS-defining cancer. This study shows that AIDS-defining cancers continue to be a problem for our country. In this study conducted in the effective ART era, it was expected that non-AIDS-defining cancers would come to the fore, while AIDS-defining cancer and non-AIDS-defining cancer were seen at a similar rate. This suggests that screening for malignancy should be started at the time of diagnosis and that the recommended screening programs should be performed appropriately during follow-up, which will facilitate early diagnosis and follow-up, and reduce mortality and morbidity. In addition, increasing awareness of HIV/AIDS in the community and ensuring that patients apply at earlier stages will also contribute to reducing unwanted outcomes such as cancer.