Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC) study group

The European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC), CHIPS Steering Committee

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Abstract

Objectives: Investigate trends over time and predictors of malignancies among children and young people with HIV. Design: Pooled data from 17 cohorts in 15 countries across Europe and Thailand. Methods: Individuals diagnosed with HIV and presenting to paediatric care less than 18 years of age were included. Time at risk began at birth for children with documented vertically acquired HIV, and from first HIV-care visit for others. Children were followed until death, loss-to-follow-up, or last visit in paediatric or adult care (where data after transfer to adult care were available). Rates of reported malignancies were calculated overall and for AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (NADM) separately. Risk factors for any malignancy were explored using Poisson regression, and for mortality following a malignancy diagnosis using Cox regression. Results: Among 9632 individuals included, 140 (1.5%) were ever diagnosed with a malignancy, of which 112 (80%) were ADM. Overall, the rate of any malignancy was 1.18 per 1000 person-years; the rate of ADM decreased over time whereas the rate of NADM increased. Male sex, being from a European cohort, vertically acquired HIV, current severe immunosuppression, current viral load greater than 400 copies/ml, older age, and, for those not on treatment, earlier calendar year, were risk factors for a malignancy diagnosis. Fifty-eight (41%) individuals with a malignancy died, a median 2.4 months (IQR 0.6-8.8) after malignancy diagnosis. Conclusion: The rate of ADM has declined since widespread availability of combination ART, although of NADM, there was a small increase. Mortality following a malignancy was high, warranting further investigation.

Original languageEnglish
Pages (from-to)1973-1985
Number of pages13
JournalAIDS
Volume35
Issue number12
DOIs
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
C.T. has received grant funding from ViiV Healthcare via the Penta Foundation (to UCL), and personally from ViiV for participation on an advisory board. C.F. has received funds for speaking at symposia organized on behalf of Gilead Sciences.

Funding Information:
Funding statement: EPPICC receives funding from the PENTA Foundation (http://penta-id.org), and received support from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 825579 for the REACH study. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (programme number MC_UU_12023/26).

Funding Information:
UK AND IRELAND: Collaborative HIV Paediatric Study (CHIPS): CHIPS is funded by the NHS (London Specialised Commissioning Group) and has received additional support from Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Gilead Sciences, Janssen and Roche. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (https://www.mrc.ac.uk) programme number MC_UU_12023/26.

Funding Information:
SPAIN: CoRISPE-cat, Catalonia: financial support for CoRISPE-cat was provided by the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida. Members: Hospital Universitari Vall d’Hebron, Barcelona [Pere Soler-Palacín, Maria Antoinette Frick and Santiago Pérez-Hoyos (statistician)], Hospital Universitari del Mar, Barcelona (Antonio Mur, Núria López), Hospital Universitari Germans Trias i Pujol, Badalona (María Méndez), Hospital Universitari JosepTrueta, Girona (Lluís Mayol), Hospital Universitari Arnau de Vilanova, Lleida (Teresa Vallmanya), Hospital Universitari Joan XXIII, Tarragona (Olga Calavia), Consorci Sanitari del Maresme, Mataró (Lourdes García), Hospital General de Granollers (Maite Coll), Corporació Sanitària Parc Taulí, Sabadell (ValentíPineda), Hospital Universitari Sant Joan, Reus (Neus Rius), Fundació Althaia, Manresa (Núria Rovira), Hospital Son Espases, Mallorca (Joaquín Dueñas) and Hospital Sant Joan de Déu, Esplugues (Clàudia Fortuny, Antoni Noguera-Julian).

Funding Information:
NETHERLANDS: The ATHENA database is maintained by Stichting HIV Monitoring and supported by a grant from the Dutch Ministry of Health, Welfare and Sport through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment.

Funding Information:
Funding: This study has been financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #177499).

Funding Information:
Funding: This work has been partially funded by the Fundación para la Investigación y Prevención de SIDA en España (FIPSE) (FIPSE 3608229/09, FIPSE 240800/09, FIPSE 361910/10), Red Temática de Investigación en SIDA (RED RIS) supported by Instituto de Salud Carlos III (ISCIII) (RD12/0017/0035 and RD12/0017/0037), project as part of the Plan R+D+I and cofinanced by ISCIII-Subdirección General de Evaluación and Fondo Europeo de Desarrollo Regional (FEDER),Mutua Madrileña 2012/0077, Gilead Fellowship 2013/0071, FIS PI15/00694,CoRISpe (RED RIS RD06/0006/ 0035 y RD06/0006/0021).

Publisher Copyright:
© 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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