Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Jan 14;32(2):171-177.
doi: 10.1097/QAD.0000000000001664.

Gynecologic cancer in HIV-infected women: treatment and outcomes in a multi-institutional cohort

Kimberly L Levinson  1 , David J Riedel  2 , Laureen S Ojalvo  1 , Wesley Chan  2 , Ana M Angarita  1 , Amanda N Fader  1 , Anne F Rositch  3   4
Affiliations
Multicenter Study

Gynecologic cancer in HIV-infected women: treatment and outcomes in a multi-institutional cohort

Kimberly L Levinson et al. AIDS. .

Abstract

Objective: To evaluate gynecologic cancer treatments in HIV-infected women for adherence to National Comprehensive Cancer Network (NCCN) guidelines and to describe survival by adherence to guidelines.

Design: Beyond cervical cancer, there are little data on treatment and outcomes for these women. This is a retrospective cohort study of HIV-infected women with gynecologic cancers.

Methods: HIV-infected women with gynecologic cancers from 2000 to 2015 were identified at two urban, comprehensive cancer centers. Chart reviews extracted demographic, HIV, and cancer-related variables. Cancer treatment was evaluated for adherence to NCCN guidelines. Overall survival was compared between those who received NCCN adherent and nonadherent cancer care.

Results: Fifty-seven women were identified; 15 vulvar (26%), 26 cervical (46%), nine ovarian (16%), and seven endometrial (12%) cancers. Median time from HIV to cancer diagnosis was 8.5 years, and 88% of women were black. Thirty patients (53%) had stage I, and 27 (47%) had stage II-IV disease. Overall, 28 women (49%) received NCCN-adherent care; 22 of 30 stage I (73%) and six of 27 stage II-IV patients (22%). Among 29 women not receiving NCCN-adherent care, 69% were due to patient-related factors or toxicity. Among women with II-IV cancers, 48-month survival was higher in women who received NCCN-adherent care than those who did not (60 versus 28%).

Conclusion: Most HIV-infected women with advanced gynecologic cancers did not receive NCCN-adherent care and had worse survival compared to those who did. Focus on treatment-related toxicities and patient-related barriers to cancer care are necessary in this population.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest and Source of Funding: Kimberly Levinson received a grant from the Johns Hopkins University Center for AIDS Research. Dr. Riedel has non-financial support from Merck, outside of the submitted work. Dr. Ojalvo receives personal fees from PapGene, Inc and from EMDSerono, both outside of the submitted work. For all other authors, no conflicts of interest were declared.

Figures

Figure 1
Figure 1
NCCN-adherent versus non-adherent treatment by stage and treatment type
Figure 2
Figure 2
Overall survival by site of gynecological malignancy.
Figure 3
Figure 3
Overall survival for those with NCCN-adherent versus non-adherent care, by cancer stage at diagnosis
See this image and copyright information in PMC

References

    1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services; [Accessed August 3, 2017]. Available at: https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Section E-1.
    1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–33. - PMC - PubMed
    1. Goedert JJ, Schairer C, McNeel TS, Hessol NA, Rabkin CS, Engels EA, et al. Risk of breast, ovary, and uterine corpus cancers among 85,268 women with AIDS. Br J Cancer. 2006;95(5):642–8. - PMC - PubMed
    1. Shiels MS, Pfeiffer RM, Gail MH, Hall HI, Li J, Chaturvedi AK, et al. Cancer burden in the HIV-infected population in the United States. J Natl Cancer Inst. 2011;103(9):753–62. - PMC - PubMed
    1. Patel P, Hanson DL, Sullivan PS, Novak RM, Moorman AC, Tong TC, et al. Incidence of types of cancer among HIV-infected persons compared with the general population in the United Sates, 1992–2003. Ann Intern Med. 2008;148(10):728–36. - PubMed

Publication types