ASSOCIATION BETWEEN HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION ANDCANCER IN THE BLACK-POPULATION OF JOHANNESBURG AND SOWETO, SOUTH-AFRICA

A case-control study of 913 black cancer patients (aged 15-50 years) w as undertaken to measure the association between human immunodeficienc y (HIV) infection and cancers believed to have an infective aetiology. Controls were patients with cancers believed not to be infective in o rigin. The prevalence of HIV in the controls of 7.3% (24 of 325) was s imilar to the background HIV seropositivity in this population. Odds r atios (ORs) and 95% confidence intervals (CI) adjusted for age, year o f diagnosis, marital status and sex were calculated. There was a stron g association between HIV infection and Kaposi's sarcoma (KS), with 27 of 33 cases being HIV seropositive, OR = 61.8 (95% CI 19.7-194.2) and an elevated association with non-Hodgkin's lymphoma (NHL), with 27 of 40 cases being HIV seropositive [OR = 4.8 (95% CI 1.5-14.8)]. The ele vated odds ratio for KS associated with HIV infection accords with the observed increases in the incidence of KS in several sub-Saharan Afri can countries where the prevalence of HIV is high. The odds ratio for NHL associated with HIV infection was lower than that reported in deve loped countries, and the reason for this is not clear. No other cancer s, including cervical and liver cancers, showed significantly elevated odds ratios associated with HIV infection.