What question did this study set out to answer?

The study aims to analyze the incidence of malignancies among individuals living with HIV in Tunisia over the past 30 years.

July 16, 2026Infectious Agents and Cancer0 citationsOpen Access

HIV-associated malignancies in Tunisia: a 30-year retrospective cohort study from a North African perspective

SYSarra YacoubHôpital Farhat Hached MSManel Ben SelmaHôpital Farhat Hached SGSouha GhachemUniversity of Sousse

Key Points

The study aims to analyze the incidence of malignancies among individuals living with HIV in Tunisia over the past 30 years.
Descriptive retrospective cohort study conducted over 30 years (1994-2024) at Farhat Hached University Hospital, Sousse, Tunisia.
Included all people living with HIV who developed at least one malignant neoplasm.
Collected epidemiological, clinical, immunovirological, pathological, and outcome data retrospectively.
Out of 655 people living with HIV, 25 patients (3.8%) developed malignancies, with 27 malignancies identified.
AIDS-defining cancers predominated (81.5%), mainly Kaposi sarcoma (44.4%) and non-Hodgkin lymphoma (33.3%).
Median overall survival was 1.9 years for AIDS-defining cancers and 3.7 years for non-AIDS-defining cancers.

Abstract

Abstract Background Despite major advances in antiretroviral therapy (ART), HIV-associated malignancies remain a significant cause of morbidity and mortality in low- and middle-income countries. In Tunisia, data on AIDS-defining cancers (ADCs) and non–AIDS-defining cancers (NADCs) among people living with HIV (PLWH) remain scarce. Methods We conducted a descriptive retrospective cohort study over a 30-year period (1994–2024) at Farhat Hached University Hospital, Sousse, Tunisia. All PLWH who developed at least one malignant neoplasm were included. Epidemiological, clinical, immunovirological, pathological, and outcome data were retrospectively collected and analyzed. Results Among 655 PLWH followed during the study period, 25 patients with a median age of 36 years developed malignancies, representing 3.8% of all PLWH. 27 malignancies were identified with 2 patients developing 2 distinct malignancies: a Kaposi sarcoma (KS) and a Non-AIDS-defining cancer (NADC). AIDS-defining cancers (ADC) predominated (81.5%), mainly KS (44.4%) and non-Hodgkin lymphoma (33.3%), while NADCs accounted for 18.5%. Cancer and HIV diagnoses were concomitant in 56% of patients ( n = 14) and 92% of malignancies occurred within the first year following HIV diagnosis. Most patients presented with advanced immunodeficiency, with median CD4 counts at tumor diagnosis of 73 cells/mm³ for ADCs and 57 cells/mm³ for NADCs. Median overall survival was 1.9 years for ADCs and 3.7 years for NADCs. Conclusions In this North African cohort, HIV-associated malignancies were predominantly AIDS-defining and affected young adults with advanced immunosuppression, reflecting late HIV diagnosis for PLWH developing malignancies. Beyond strengthening early HIV testing and timely ART initiation, targeted patient education focusing on high-risk behaviors, along with efforts to reduce HIV-related stigma, are essential components to improve cancer prevention, early diagnosis, and outcomes among PLWH in resource-limited settings.

问 AI

Bookmark

View Full Paper