Cancer patterns in people living with HIV/AIDS in Türkiye: A 15-year retrospective cohort

Background With the widespread use of highly active antiretroviral therapy (HAART), the life expectancy of people living with HIV/AIDS (PLWHA) has increased substantially. Consequently, the cancer profile in this population has shifted, with a declining incidence of AIDS-defining cancers (ADCs) and a growing burden of non-AIDS-defining cancers (NADCs). Methods We retrospectively reviewed 1,419 PLWHA followed between January 2010 and December 2024 at a tertiary referral center in Türkiye. Demographic, clinical, and laboratory data, including CD4 counts and HIV RNA levels, were collected. Cancer diagnoses were confirmed by histopathological examination, and their prevalence was determined. Results A total of 66 patients (4.6%) were diagnosed with cancer; 31 (47%) had ADCs and 35 (53%) had NADCs. Kaposi sarcoma (58.9%) most frequent ADCs, while gastrointestinal cancers (28.6%) predominated among NADCs. Late presenters (CD4 < 200 cells/mm³) accounted for 51.5% of all cancer cases and 71% of ADCs. Mortality was higher in patients with NADCs (37.1%) compared to ADCs (22.6%). Conclusions Our findings demonstrate a predominance of NADCs over ADCs among PLWHA, largely reflecting prolonged survival in the HAART era. The high proportion of late presenters and the increased burden of NADCs underscore the need for earlier HIV diagnosis, comprehensive follow-up, and integration of cancer screening strategies particularly for gastrointestinal malignancies and HPV-related cancers into routine HIV care.