. 2022 Jul 15;151(2):209-221.

doi: 10.1002/ijc.33981. Epub 2022 Mar 4.

Impact of HIV infection on survival among women with stage I-III breast cancer: Results from the South African breast cancer and HIV outcomes study

Oluwatosin A Ayeni^{1

2}, Daniel S O'Neil³, Yoanna S Pumpalova⁴, Wenlong Carl Chen^{1

5

6}, Sarah Nietz^{1

7}, Boitumelo Phakathi^{1

7}, Ines Buccimazza⁸, Sharon Čačala^{9

10}, Laura W Stopforth⁹, Hayley A Farrow^{1

9}, Witness Mapanga^{1

2}, Maureen Joffe^{1

11

12}, Tobias Chirwa¹³, Valerie McCormack¹⁴, Judith S Jacobson^{15

16}, Katherine D Crew^{4

15

16}, Alfred I Neugut^{4

15

16}, Paul Ruff^{1

2

11}, Herbert Cubasch^{1

7

11}

Affiliations

¹ Non-communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa.
² Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
³ Sylvester Comprehensive Cancer Center and Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA.
⁴ Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
⁵ National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa.
⁶ Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁷ Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁸ Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezana Hospital, University of KwaZulu-Natal, Empangeni, KwaZulu-Natal, South Africa.
⁹ Department of Surgery and Radiation Oncology, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa.
¹⁰ Department of Surgery, Ngwelezana Hospital, Empangeni and University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
¹¹ South Africa Medical Research Council Common Epithelial Cancers Research Center, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹² SAMRC/Wits Developmental Pathways to Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹³ School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
¹⁵ Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
¹⁶ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.

PMID: 35218568
PMCID: PMC9133061
DOI: 10.1002/ijc.33981

Impact of HIV infection on survival among women with stage I-III breast cancer: Results from the South African breast cancer and HIV outcomes study

Oluwatosin A Ayeni et al. Int J Cancer. 2022.

. 2022 Jul 15;151(2):209-221.

doi: 10.1002/ijc.33981. Epub 2022 Mar 4.

Authors

Affiliations

¹ Non-communicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa.
² Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
³ Sylvester Comprehensive Cancer Center and Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA.
⁴ Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
⁵ National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa.
⁶ Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁷ Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁸ Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezana Hospital, University of KwaZulu-Natal, Empangeni, KwaZulu-Natal, South Africa.
⁹ Department of Surgery and Radiation Oncology, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa.
¹⁰ Department of Surgery, Ngwelezana Hospital, Empangeni and University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
¹¹ South Africa Medical Research Council Common Epithelial Cancers Research Center, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹² SAMRC/Wits Developmental Pathways to Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹³ School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
¹⁵ Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
¹⁶ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.

PMID: 35218568
PMCID: PMC9133061
DOI: 10.1002/ijc.33981

Abstract

In some countries of sub-Saharan Africa, the prevalence of HIV exceeds 20%; in South Africa, 20.4% of people are living with HIV. We examined the impact of HIV infection on the overall survival (OS) of women with nonmetastatic breast cancer (BC) enrolled in the South African Breast Cancer and HIV Outcomes (SABCHO) study. We recruited women with newly diagnosed BC at six public hospitals from 1 July 2015 to 30 June 2019. Among women with stages I-III BC, we compared those with and without HIV infection on sociodemographic, clinical, and treatment factors. We analyzed the impact of HIV on OS using multivariable Cox proportional hazard models. Of 2367 women with stages I-III BC, 499 (21.1%) had HIV and 1868 (78.9%) did not. With a median follow-up of 29 months, 2-year OS was poorer among women living with HIV (WLWH) than among HIV-uninfected women (72.4% vs 80.1%, P < .001; adjusted hazard ratio (aHR) 1.49, 95% confidence interval (CI) = 1.22-1.83). This finding was consistent across age groups ≥45 years and <45 years, stage I-II BC and stage III BC, and ER/PR status (all P < .03). Both WLWH with <50 viral load copies/mL and WLWH with ≥50 viral load copies/mL had poorer survival than HIV-uninfected BC patients [aHR: 1.35 (1.09-1.66) and 1.54 (1.20-2.00), respectively], as did WLWH who had ≥200 CD4+ cells/mL at diagnosis [aHR: 1.39 (1.15-1.67)]. Because receipt of antiretroviral therapy has become widespread, WLWH is surviving long enough to develop BC; more research is needed on the causes of their poor survival.

Keywords: HIV; South Africa; breast cancer; overall survival.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest:

AIN: I have consulted for Otsuka, Eisai, GlaxoSmithKline, United biosource Corp, Hospira. I have grant support from Otsuka. I am on the medical advisory board of EHE Intl.

All other authors declare that they have no conflict of interest.

Figures

**Figure 1:**
Overall Survival in Women with Stages I-III Breast Cancer Enrolled in the SABCHO cohort by HIV status and by age group.

**Figure 2:**
Overall Survival in Women with Stages I-III Breast Cancer Enrolled in the SABCHO cohort by (A) & (B) HIV status and stage, and (C) & (D) HIV status and Breast Cancer Hormone receptor status

**Figure 3:**
Overall Survival in Women Living with HIV with Stages I-III Breast Cancer Enrolled in the SABCHO cohort, by (A) Viral Load and (B) CD4 count at Breast Cancer diagnosis.

See this image and copyright information in PMC

References

1. UNAIDS. AIDS Data, 2016. Available at: https://www.unaids.org/sites/default/files/media_asset/global-AIDS-updat....
1. Grover S, Martei YM, Puri P, Prabhakar P, Mutebi M, Balogun OD, Price AJ, Freeman AH, Narasimhamurthy M, Rodin D, Rayne S, Zetola NM. Breast Cancer and HIV in Sub-Saharan Africa: A Complex Relationship. Journal of Global Oncology 2018: 1–11. - PMC - PubMed
1. Prager GW, Braga S, Bystricky B, Qvortrup C, Criscitiello C, Esin E, Sonke GS, Martínez GA, Frenel J-S, Karamouzis M. Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO open 2018;3: e000285. - PMC - PubMed
1. Coghill AE, Han X, Suneja G, Lin CC, Jemal A, Shiels MS. Advanced stage at diagnosis and elevated mortality among US patients with cancer infected with HIV in the National Cancer Data Base. Cancer 2019;125: 2868–76. - PMC - PubMed
1. Coghill AE, Pfeiffer RM, Shiels MS, Engels EA. Excess mortality among HIV-infected individuals with cancer in the United States. Cancer Epidemiology and Prevention Biomarkers 2017;26: 1027–33. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Impact of HIV infection on survival among women with stage I-III breast cancer: Results from the South African breast cancer and HIV outcomes study

Affiliations

Impact of HIV infection on survival among women with stage I-III breast cancer: Results from the South African breast cancer and HIV outcomes study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials