Immunosuppression level at the time of diagnosis of AIDS-defining malignancies in São Paulo State, Brazil
A.L.d.C.C. Toscano1,2, L.F. Jamal3, Â. Tayra3, M.C. Polon3, A. Gonçalves3
1STD/Aids Reference and Training Center, Day-Hospital, São Paulo, Brazil, 2Emilio Ribas Infectious Diseases Institute, Day-Hospital, São Paulo, Brazil, 3STD/Aids Reference and Training Center, São Paulo, Brazil
Background: There are few studies on malignancies associated with AIDS in Brazil. Those malignancies are found to be highly correlated with the degree of immunodeficiency. The aim of the present study is to describe the level of immunosuppression at the time of diagnosis of AIDS-defining malignancies (ADM) in São Paulo State, Brazil.
Methods: Patients notified with AIDS and either Kaposi's sarcoma (KS), Non-Hodgkin lymphoma (NHL), Central Nervous System (CNS) lymphoma or Invasive Cervix Cancer (CC) during the years 2007-2008 in São Paulo State-Brazil were selected at Notifiable Diseases Information System (SINAN). These results were linked to Control System for Laboratory Tests (SISCEL) database and the CD4 count cells collected closest to AIDS/Cancer diagnosis was obtained. Patients with other opportunistic infection at notification form were excluded. Age, gender and AIDS risk exposure factor informations were also collected.
Results: Three hundred and two patients were diagnosed with AIDS and ADM in 2007-2008. Eighty patients with other AIDS-defining conditions on notification form were excluded. Only one hundred and fourteen patients had corresponding CD4 count in SISCEL. The most frequent ADM was KS (58 male and 9 female), with a total of 67 records; 64.1% had CD4 count < 200 cells/mm3 at time of AIDS/KS diagnosis. Thirty three patients presented LNH (27 male and 6 female); 33.3% had CD4 count < 200 cells/mm3. Thirteen patients presented CC; 46.1% had CD4 count < 200 cells/mm3. One 29-year-old male patient was notified with CNS lymphoma (CD4 = 49 cells/mm3).The most frequent AIDS risk factor reported for all ADM was heterosexual transmission. The mean age was 44 years-old.
Conclusions: The majority of ADM patients presented low CD4 count at time of diagnosis, especially those with KS. The early detection of HIV infection may prevent the development of AIDS malignancies.
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