Women with HIV may have higher breast cancer mortality
A study from Botswana, presented at CROI 2019, found that HIV-positive women with breast cancer appear to have decreased survival rates compared with HIV-negative women. Having HIV was associated with a nearly twofold reduction in survival.
While prior research in the US and Africa has found that women with HIV do not have higher breast cancer incidence, or likelihood of developing cancer, some studies with a small number of HIV-positive participants suggested that survival may be reduced.
This prospective analysis drew from the Thabatse Cancer Cohort, which enrolled nearly 4000 people with cancer at four major oncology centres in Botswana. Participants are evaluated at study entry and followed for five years. The breast cancer cohort included 510 women who sought cancer care between October 2010 and September 2018. Of these, 151 were HIV positive and 327 were HIV negative.
The women in the HIV-positive group were a few years younger than the HIV-negative group, on average, but the two groups were similar in terms of breast cancer stage and type. Types of cancer treatment also did not differ significantly by HIV status. The majority of the women living with HIV were taking HIV treatment and around 70% had a viral load below 1000 copies/ml.
During the course of the study, 70 HIV-positive women (46%) and 101 HIV-negative women (31%) died. In a multivariate analysis controlling for other factors, HIV-positive women had an 82% reduction in survival compared with HIV-negative women.
Dr Katrin Sadigh, presenting, emphasised that survival was poor for both HIV-positive and HIV-negative women in this study, and better strategies are needed to speed up diagnosis and improve care.