low and middle income countries; cancer epidemiology; HIV/AIDS; antiretroviral therapy; sub-Saharan Africa; health services research; record linkage studies; cohort studies
Coleman J. S., Cespedes M. S., Cu-Uvin S., Kosgei R. J., Maloba M., Anderson J., Wilkin T., Jaquet A., Bohlius J., Anastos K., Wools-Kaloustian K. (2016), An Insight Into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa, in J Low Genit Tract Dis
, 20, 31-7.
Rohner E., Wyss N., Heg Z., Faralli Z., Mbulaiteye S. M., Novak U., Zwahlen M., Egger M., Bohlius J. (2016), HIV and human herpesvirus 8 co-infection across the globe: Systematic review and meta-analysis, in Int J Cancer
, 138, 45-54.
Bohlius J., Maxwell N., Spoerri A., Wainwright R., Sawry S., Poole J., Eley B., Prozesky H., Rabie H., Garone D., Technau K. G., Maskew M., Davies M. A., Davidson A., Stefan D. C., Egger M. (2016), Incidence of AIDS-defining and Other Cancers in HIV-positive Children in South Africa: Record Linkage Study, in Pediatr Infect Dis J
, 35, 164-70.
Begre L., Rohner E., Mbulaiteye S. M., Egger M., Bohlius J. (2016), Is human herpesvirus 8 infection more common in men than in women? Systematic review and meta-analysis, in Int J Cancer
, 139, 776-83.
Freeman E., Semeere A., Wenger M., Bwana M., Asirwa F. C., Busakhala N., Oga E., Jedy-Agba E., Kwaghe V., Iregbu K., Jaquet A., Dabis F., Yumo H. A., Dusingize J. C., Bangsberg D., Anastos K., Phiri S., Bohlius J., Egger M., Yiannoutsos C., Wools-Kaloustian K., Martin J. (2016), Pitfalls of practicing cancer epidemiology in resource-limited settings: the case of survival and loss to follow-up after a diagnosis of Kaposi's sarcoma in five countries across sub-Saharan Africa, in BMC Cancer
, 16, 65-65.
Sengayi M., Spoerri A., Egger M., Kielkowski D., Crankshaw T., Cloete C., Giddy J., Bohlius J. (2016), Record linkage to correct under-ascertainment of cancers in HIV cohorts: The Sinikithemba HIV clinic linkage project, in Int J Cancer
, 139, 1209-16.
Sommer G., Gianinazzi M. E., Kuonen R., Bohlius J., l'Allemand D., Hauschild M., Mullis P. E., Kuehni C. E. (2015), Health-Related Quality of Life of Young Adults Treated with Recombinant Human Growth Hormone during Childhood, in PLoS One
, 10, 0140944-0140944.
Bohlius J., Maskew M., Davies M. A., Egger M. (2015), HHV-8 seroprevalence in HIV-positive and HIV-negative populations, in Int J Cancer
, 136, 1243-1243.
Background: There is little data on the effect of HIV and antiretroviral therapy (ART) on the cancer epidemiology in Sub-Saharan Africa, where most people with HIV/AIDS life. In many African countries access to cancer screening, treatment or palliative care is limited. With the scale-up of combination ART in Africa the prognosis of individuals living with HIV/AIDS has been improved substantially, however, the burden of cancer in the HIV-infected population and the implications for treatment and outcomes in the era of ART are unclear. Objectives: I propose clinical, epidemiological and health services research to inform the prevention and care of HIV-related cancers in Southern Africa. I will address the three following three objectives:1.To compare incidence rates, survival and the impact of ART in HIV-infected children and adults developing AIDS-defining cancer in Southern Africa, Europe, Southern, Central and Northern America, Asia/Pacific and Australia.2.To examine the provision of health care to patients with Kaposi Sarcoma in Southern Africa3.To evaluate the incidence and survival of AIDS-defining cancer and non AIDS-defining cancer in patients attending ART programs in South Africa through linkage to the National Cancer Registry. Methods: This study will build on a large NIH-funded network of HIV cohorts, the International epidemiological Databases to Evaluate AIDS (IeDEA) and its European partner, the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). In the past years I have retrieved data for 68 participating cohorts from 38 countries in five continents (Southern Africa, Europe, North America, Central and South America, Asia/Pacific and Australia). The data set includes 913,041 HIV-infected children and adults, 25,674 AIDS-defining cancers (Kaposi Sarcoma (KS), Non Hodgkin Lymphoma (NHL), invasive cervical cancer (ICC)) have been diagnosed in these patients. The incidence rate for KS, NHL and ICC will be calculated by dividing the number of patients developing the disease by the number of person-years at risk. Survival of patients with KS, NHL or ICC will be assessed in time to event analyses, measuring time from the date of cancer diagnosis until death from any cause or the date the patient was last known to be alive. I will use competing risk models to analyse the time to a cancer diagnosis, loss to follow-up or death. I will collaborate with physicians at HIV and oncology departments in Malawi, Zambia and South Africa to evaluate the provision of care for patients diagnosed with KS. I will extract and analyse data for exact diagnosis and stage, treatment received and treatment outcomes. Deterministic and probabilistic linkages of two South African HIV cohorts with the data from the National Cancer Registry will be performed. Non AIDS-defining cancers, which are not routinely recorded in HIV cohorts, will thus be identified. The study will be done in close cooperation with collaborators in Southern Africa, Europe, North and South America, Asia/Pacific and Australia as well as the HIV/AIDS and cancer research groups at ISPM Bern. Significance: This project was designed to respond to the operational and clinical research priorities identified by the World Health Organization and other national and international agencies. This research will be a build on international research networks and provides a unique opportunity to advance cancer epidemiology in HIV-infected patients in Southern Africa.