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. 2022 Dec 12;14(24):6129.
doi: 10.3390/cancers14246129.

Incidence and Clinical Description of Lymphomas in Children and Adolescents with Vertical Transmission of HIV in Rio de Janeiro, Brazil, in Pre- and Post-Combined Antiretroviral Therapy Eras: A Multicentric Hospital-Based Survival Analysis Study

Nathalia Lopez Duarte  1   2   3 , Ana Paula Silva Bueno  3   4 , Bárbara Sarni Sanches  1   3 , Gabriella Alves Ramos  3   5 , Julia Maria Bispo Dos Santos  1   3 , Henrique Floriano Hess E Silva  1   3 , Janaina de Oliveira Pondé  1   3 , José Gilberto de Sá  6 , Priscila Mazucanti Rossi  6 , Patricia Regina Cavalcanti Barbosa Horn  7 , Denise Cardoso das Neves Sztajnbok  8 , Norma de Paula Motta Rubini  9 , Cristiane Bedran Milito  1   10 , Thalita Fernandes de Abreu  1   11 , Marcelo Gerardin Poirot Land  1   2   3   4
Affiliations

Incidence and Clinical Description of Lymphomas in Children and Adolescents with Vertical Transmission of HIV in Rio de Janeiro, Brazil, in Pre- and Post-Combined Antiretroviral Therapy Eras: A Multicentric Hospital-Based Survival Analysis Study

Nathalia Lopez Duarte et al. Cancers (Basel). .

Abstract

The incidence of cancer in children living with HIV (CLWH) is high and lymphomas are the most common type of cancer in this population. The combined antiretroviral therapy (cART) changed the natural history of HIV infection. To determine the incidence and profile of these CLWH malignancies in Rio de Janeiro (RJ), Brazil, we conducted a retrospective and observational study of vertically infected CLWH, ranging from 0−20 incomplete years, from 1995 to 2018, at five reference centers. The study period was divided into three eras in accordance with the widespread use of cART in Brazil. 1306 patients were included. Of the 25 lymphomas found, 19 were AIDS-defining malignancies (ADM); 6 were non-AIDS-defining malignancies (NADM). The incidence rate (IR) of lymphoma developing was 1.70 per 1000 children-year (95% CI 1.09−2.50). ADM development IR decreased from 2.09−1.75−0.19 per 1000 children-year (p < 0.001) through cART eras. Cumulative Nelson−Aalen hazards of developing ADM over a 20-year period were 3.73% in the Early-cART era, 3.07% in the Mid-cART era, and 0.32% in the Late-cART era (p = 0.013). This study demonstrates the IR of lymphoma in CLWH in RJ, Brazil, as well as the benefit of cART in reducing ADM and death occurrence in the Post-cART era.

Keywords: Brazil; HIV; combined antiretroviral therapy (cART); epidemiology; incidence; lymphoma; pediatric; vertical transmission (VT).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence Rate (IR) of HIV-related Lymphoma for the Global cohort through Eras, by Sex.
Figure 2
Figure 2
Nelson–Aalen Cumulative Hazards of Developing Lymphoma for HIV-vertically Infected Children per Era for all Lymphoma subtypes (A), ADM (B), and NADM (C).
Figure 3
Figure 3
Cumulative Incidence (Competing Risk Model) for Death not related to Lymphoma or for ADM or NADM development in 30 years of evolution.
Figure 4
Figure 4
Lymphoma subtypes found in the cohort according to Age group at diagnosis. Abbreviations: Anaplastic Large Cell Lymphoma (ALCL CD30+/ALK+); Burkitt Lymphoma (BL); Diffuse Large B-Cell Lymphoma (DLBCL); Nodular Sclerosis Classical Hodgkin Lymphoma (NSCHL); Peripheral T-Cell Lymphoma (PTCL).
See this image and copyright information in PMC

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