Malignancies in UK children with HIV infection acquired from mother to child transmission
a Department of Paediatrics, Imperial College
School of Medicine at St Mary's, London, b Department of Epidemiology and Biostatistics, Institute of
Child Health, London, c Department of Haematology and
Oncology, Great Ormond Street Hospitals for Children NHS Trust, London
Correspondence to: Dr D M Gibb, Department of Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH.
Accepted 19 November 1996
By April 1995, 302 cases of vertically acquired HIV infection
had been reported through the British Paediatric Association Surveillance Unit. Over 50% of these children had developed an AIDS
indicator disease, including nine malignancies (seven cases of
non-Hodgkin's lymphoma (NHL) and two of Kaposi's sarcoma). There were
two other malignancies that were not AIDS indicator diseases. In
children less than 5 years of age the incidence of NHL was
approximately 2500 times greater than expected in the UK child
population. Three children presented with NHL as their AIDS indicator
disease and four developed NHL at a median of 14 (range 10-19) months
after the initial diagnosis of AIDS. Six of the seven children died at
a median of 6.5 (range 2-14) months after the diagnosis of NHL. The
seventh child responded to treatment and is alive nearly four years
later. Histology was available in five cases, of which four were of B
cell and one of T cell origin. Epstein-Barr virus was detected in all
three patients with NHL where it was sought; all had B cell lymphomas.
Although comparatively rare, malignancies occur in children infected
with HIV and may be the presenting illness. Paediatricians now need to
consider HIV infection as a predisposing cause of childhood cancer,
especially NHL.
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