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. 2024 Dec 15;155(12):2149-2158.
doi: 10.1002/ijc.35091. Epub 2024 Aug 11.

Cancer risk among people living with Human Immunodeficiency Virus (HIV) in Rwanda from 2007 to 2018

Jean Claude Dusingize  1 , Gad Murenzi  2 , Benjamin Muhoza  2 , Lydia Businge  3 , Eric Remera  3 , Francois Uwinkindi  3 , Marc Hagenimana  3 , Gallican Rwibasira  3 , Sabin Nsanzimana  4 , Philip E Castle  5 , Kathryn Anastos  6 , Gary M Clifford  7
Affiliations

Cancer risk among people living with Human Immunodeficiency Virus (HIV) in Rwanda from 2007 to 2018

Jean Claude Dusingize et al. Int J Cancer. .

Abstract

Assessing the risk of cancer among people living with HIV (PLHIV) in the current era of antiretroviral therapy (ART) is crucial, given their increased susceptibility to many types of cancer and prolonged survival due to ART exposure. Our study aims to compare the association between HIV infection and specific cancer sites in Rwanda. Population-based cancer registry data were used to identify cancer cases in both PLHIV and HIV-negative persons. A probabilistic record linkage approach between the HIV and cancer registries was used to supplement HIV status ascertainment in the cancer registry. Associations between HIV infection and different cancer types were evaluated using unconditional logistic regression models. We performed several sensitivity analyses to assess the robustness of our findings and to evaluate the potential impact of different assumptions on our results. From 2007 to 2018, the cancer registry recorded 17,679 cases, of which 7% were diagnosed among PLHIV. We found significant associations between HIV infection and Kaposi's Sarcoma (KS) (adjusted odds ratio [OR]: 29.1, 95% CI: 23.2-36.6), non-Hodgkin lymphoma (NHL) (1.6, 1.3-2.0), Hodgkin lymphoma (HL) (1.6, 1.1-2.4), cervical (2.3, 2.0-2.7), vulvar (4.0, 2.5-6.5), penile (3.0, 2.0-4.5), and eye cancers (2.2, 1.6-3.0). Men living with HIV had a higher risk of anal cancer (3.1, 1.0-9.5) than men without HIV, but women living with HIV did not have higher risk than women without HIV (1.0, 0.2-4.3). Our study found that in an era of expanded ART coverage in Rwanda, HIV is associated with a broad range of cancers, particularly those linked to viral infections.

Keywords: HIV infection; cancer; data linkage; epidemiology.

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Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflicts of interest to disclose except for Dr. Kathryn Anastos who has received funding from the United States National Institutes of Health (NIH) through four grants awarded to her institution.

Figures

Figure 1.
Figure 1.. Association of HIV infection with specific cancers diagnosed in Rwanda, 2007–2018.
Odds ratios are determined using logistic regression models adjusting for age, gender (where applicable), place of residence and year of cancer diagnosis. Head and neck include oropharynx.
See this image and copyright information in PMC

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