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Cited by 72Viral-associated cancers and disordersHIV/AIDS Research and InterventionsCervical Cancer and HPV Research

The burden of cancers associated with HIV in the South African public health sector, 2004–2014: a record linkage study

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Dhokotera, Tafadzwa, Bohlius, Julia, Spoerri, Adrian, Egger, Matthias, Ncayiyana, Jabulani, Olago, Victor, Singh, Elvira, Sengayi, Mazvita·2019·Infectious Agents and Cancer
DOI 10.1186/s13027-019-0228-7PMC PMC6500038
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Abstract

INTRODUCTION: The impact of South Africa's high human immunodeficiency virus (HIV) burden on cancer risk is not fully understood, particularly in the context of antiretroviral treatment (ART) availability. We examined national cancer trends and excess cancer risk in people living with HIV (PLHIV) compared to those who are HIV-negative. METHODS: We used probabilistic record linkage to match cancer records provided by the National Cancer Registry to HIV data provided by the National Health Laboratory Service (NHLS). We also used text search of specific HIV terms from the clinical section of pathology reports to determine HIV status of cancer patients. We used logistic and Joinpoint regression models to evaluate the risk and trends in cancers in PLHIV compared to HIV-negative patients from 2004 to 2014. In sensitivity analysis, we used inverse probability weighting (IPW) to correct for possible selection bias. RESULTS: = 30,486) with a known status were HIV-positive. PLHIV were at higher risk of AIDS-defining cancers (Kaposi sarcoma [adjusted OR:134, 95% CI:111-162], non-Hodgkin lymphoma [adjusted OR:2.73, 95% CI:2.56-2.91] and, cervix [adjusted OR:1.70, 95% CI:1.63-1.77], conjunctival cancer [adjusted OR:21.5, 95% CI:16.3-28.4] and human papilloma virus (HPV) related cancers (including; penis [adjusted OR:2.35, 95% CI:1.85-2.99], and vulva [adjusted OR:1.94, 95% CI:1.67-2.25]) compared to HIV-negative patients. Analysis using the IPW population yielded comparable results. CONCLUSION: There is need for improved awareness and screening of conjunctival cancer and HPV-associated cancers at HIV care centres. Further research and discussion is warranted on inclusive HPV vaccination in PLHIV.

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  • Women living with HIV face a six-to-tenfold increased risk of cervical cancer compared to HIV-negative women.

    “Women living with HIV (WLHIV) face an almost six-to-ten-fold increased risk of cervical cancer compared to HIV-negative women [8–10].”

    From HPV Screening in Women Living with HIV (WLHIV) in Karnataka, India: Can it be Integrated into ART Centres? (2025) · cites this paper as [9]

    The Results (Table 2; page unavailable) report a higher cervical-cancer association among people living with HIV, but the adjusted odds ratio is 1.70 (95% CI 1.63–1.77), not six- to tenfold. The paper also reports odds, rather than a six- to tenfold increase in risk. (LLM, conf=0.90)

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Authors
Dhokotera, T., Bohlius, J., Spoerri, A., Egger, M., Ncayiyana, J., Olago, V., Singh, E., & Sengayi, M.
Affiliations
  • National Health Laboratory Service (ZA)
  • University of Bern (CH)
  • University of Cape Town (ZA)
Corresponding author
Dhokotera, Tafadzwa
ORCID
Venue
Infectious Agents and Cancer
Publisher
Springer Science and Business Media LLC
Published
2019-05-03
Volume
14
Issue
1
Pages
12-12
ISSN
1750-9378 (ISSN-L)
DOI
10.1186/s13027-019-0228-7
PMC
PMC6500038
OpenAlex
W2944332154
Cited by
72
References
1
Citations by year
2026: 4 · 2025: 6 · 2024: 14 · 2023: 11 · 2022: 15 · 2021: 12 · 2020: 9 · 2018: 1
FWCI
3.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Infectious Agents and Cancer (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Open University of Cape Town (University of Cape Town) (submittedVersion)
  • Open Access CRIS of the University of Bern
Funders
  • CRDF Global (DAA3-16-62705-1)
  • National Institutes of Health (U01AI069924-09,)
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (320030_169967)
Topics
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Keywords
HIV-associated cancer, people living with HIV, AIDS-defining cancers, Kaposi's sarcoma, non-Hodgkin lymphoma, cervical cancer, HPV-associated cancers, penile cancer, vulvar cancer, cancer incidence trends, antiretroviral therapy, South Africa

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