HIV-related malignancies: community-based study using linkage of cancer registry and HIV registry data

For people immunosuppressed by human immunodeficiency virus (HIV), we expec t an increase in cancer incidence similar to that documented in transplant patients. We examined the cancer spectrum in an HIV-infected cohort, specif ically malignancies not currently associated with acquired immunodeficiency syndrome (AIDS), in relation to the general population. Cancer incidence d ata for residents of Harris County, Texas, diagnosed between 1975 and 1994, were linked to HIV/AIDS registry data by Sounder code and date of birth to identify malignancies in an HIV-infected cohort of 14,986 persons. Inciden ce of cancer in this cohort was compared to the general population by stand ardized incidence ratio (SLR) analysis. From the HIV-infected cohort, 2289 persons (15%) were identified as having one or more malignancies, with 97% occurring in males. The linkage alone identified 29.5% of the malignancies, of which only 28.7% were diagnosed in males. Adjusting for age, HIV-infect ed men and women had incidences of cancer that were 16.7 [95% confidence in terval (CI) 16.1-17.3] and 2.9 (95% CI 2.3-3.7) times that expected for the general population of Harris County, Texas. Besides Kaposi's sarcoma, non- Hodgkin's lymphoma, cervix cancer and brain lymphoma, non-AIDS related mali gnancies of Hodgkin's lymphoma, non-melanotic skin cancer in males and colo n cancer in females, exhibited significant SIRs of 5.6 (95% CI 3.6-8.4), 6. 9 (95% CI 4.8-9.5) and 4.0 (95% CI 1.1-10.2). Increased incidences of lung, prostate and breast malignancies were not seen in this HIV cohort. Persons infected with HIV appear to be at increased risk for the non-AIDS related malignancies, Hodgkin's lymphoma, non-melanotic skin cancer in males and co lon cancer in females.