Awachana JiamsakulMark PolizzottoStephane Wen-Wei KuJunko TanumaEugenie HuiRomanee ChaiwarithSasisopin KiertiburanakulAnchalee AvihingasanonEvy YunihastutiNagalingeswaran KumarasamyPenh Sun LySanjay PujariRossana DitangcoCuong Duy DoTuti Parwati MeratiPacharee KantipongFujie ZhangKinh Van NguyenAdeeba KamarulzamanJun Yong ChoiBenedict L.H. SimOon Tek NgJeremy RossWingwai WongHospital Sungai BulohBeijing Ditan Hospital Capital Medical UniversityVHS Medical Centre IndiaGokilaBach Mai HospitalUniversitas UdayanaUniversity of Indonesia, RSUPN Dr. Cipto MangunkusumoChulalongkorn UniversityKirby InstituteNational Center for Global Health and MedicineYonsei University College of MedicineFaculty of Medicine, Ramathibodi Hospital, Mahidol UniversityQueen Elizabeth Hospital Hong KongUniversity of Malaya Medical CentreVeterans General Hospital-TaipeiTan Tock Seng HospitalChiang Mai UniversityNational Hospital for Tropical DiseasesFoundation for AIDS ResearchInstitute of Infectious DiseasesChiangrai Prachanukroh HospitalUniversity of Health Sciences2020-01-272020-01-272019-03-01Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.3 (2019), 301-30710779450152541352-s2.0-85061481888https://repository.li.mahidol.ac.th/handle/20.500.14594/51850© 2018 Wolters Kluwer Health, Inc. Background:Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia.Methods:Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier.Results:Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/μL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/μL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/μL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy.Conclusions:Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.Mahidol UniversityMedicineArticleSCOPUS10.1097/QAI.0000000000001918