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Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand

Chappell, E; Group Authorship: The European Pregnancy and Paediatric Infectio; (2021) Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand. AIDS 10.1097/QAD.0000000000002965. (In press). Green open access

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Abstract

OBJECTIVES: Investigate trends over time and predictors of malignancies among children and young people with HIV. DESIGN: Pooled data from 17 cohorts in 15 countries across Europe and Thailand. METHODS: Individuals diagnosed with HIV and presenting to paediatric care <18 years of age were included. Time at risk began at birth for children with documented vertically-acquired HIV, and from first HIV-care visit for others. Children were followed until death, loss-to-follow-up, or last visit in paediatric or adult care (where data after transfer to adult care were available). Rates of reported malignancies were calculated overall and for AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (NADM) separately. Risk factors for any malignancy were explored using Poisson regression, and for mortality following a malignancy diagnosis using Cox regression. RESULTS: Among 9,632 individuals included, 140 (1.5%) were ever diagnosed with a malignancy, of which 112 (80%) were ADM. Overall, the rate of any malignancy was 1.18 per 1,000 person-years; the rate of ADM decreased over time while the rate of NADM increased. Male sex, being from a European cohort, vertically-acquired HIV, and current severe immunosuppression, viral load >400 copies/mL, older age and, for those not on treatment, earlier calendar year, were risk factors for a malignancy diagnosis. 58 (41%) of individuals with a malignancy died, a median 2.4 months (IQR 0.6, 8.8) after malignancy diagnosis. CONCLUSION: The rate of ADM has declined since widespread availability of combination ART, although of NADM there was a small increase. Mortality following a malignancy was high, warranting further investigation.

Type: Article
Title: Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000002965
Publisher version: http://dx.doi.org/10.1097/QAD.0000000000002965
Language: English
Additional information: This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10129085
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