The spectrum of HIV-1 related cancers in South Africa


  • Freddy Sitas and Valerie Beral devised and are the principal investigators of our study. Moosa Patel, Paul Ruff, Ranjan Sur, Martin Hale, David Saffer, Pradeep Rowji and Myles Connor assisted with the refinement of the study, patient recruitment, follow-up, counseling and with the classification of difficult conditions. Ute Jentsch managed the laboratory testing of the blood specimens. Rosana Pacella-Norman and Henri Carrara managed the interviewers, processing of specimens, data entry, verification and aspects of the analysis. Valerie Beral, Diana Bull, Rob Newton and Freddy Sitas produced the final tabulations. All authors contributed to the analysis of the data and to the writing of the article.


Despite the high prevalence of infection by the Human Immunodeficiency Virus (HIV) in South Africa, information on its association with cancer is sparse. Our study was carried out to examine the relationship between HIV and a number of cancer types or sites that are common in South Africa. A total of 4,883 subjects, presenting with a cancer or cardiovascular disease at the 3 tertiary referral hospitals in Johannesburg, were interviewed and had blood tested for HIV. Odds ratios associated with HIV infection were calculated by using unconditional logistic regression models for 16 major cancer types where data was available for 50 or more patients. In the comparison group, the prevalence of HIV infection was 8.3% in males and 9.1% in females. Significant excess risks associated with HIV infection were found for Kaposi's sarcoma (OR=21.9, 95% CI=12.5–38.6), non-Hodgkin lymphoma (OR=5.0, 95%CI=2.7–9.5), vulval cancer (OR=4.8, 95%CI=1.9–12.2) and cervical cancer (OR=1.6, 95%CI=1.1–2.3) but not for any of the other major cancer types examined, including Hodgkin disease, multiple myeloma and lung cancer. In Johannesburg, South Africa, HIV infection was associated with significantly increased risks of Kaposi's sarcoma, non-Hodgkin lymphoma and cancers of the cervix and the vulva. The relative risks for Kaposi's sarcoma and non-Hodgkin lymphoma associated with HIV infection were substantially lower than those found in the West. Int. J. Cancer 88:489–492, 2000. © 2000 Wiley-Liss, Inc.