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Study of cancer in children with AIDS finds links to infection by Epstein-Barr virus and immunodeficiency

San Antonio (May 22, 2003) — Which factors increase the risk of malignant cancer in children infected with the human immunodeficiency virus (HIV)? A six-year national study, reported in the May 14 issue of the Journal of the American Medical Association, raises that question and sounds the call for further study. The corresponding author is Brad H. Pollock, M.P.H., Ph.D., of The University of Texas Health Science Center at San Antonio.

The study compared clinical and laboratory factors from 43 HIV-positive children, who were identified through the national Pediatric Oncology Group, with the same information from 74 children who did not have malignancies. Patients were enrolled between 1992 and 1998. The study examined several factors, including the way the children were infected with HIV (either through transmission from the mother or from contaminated blood or blood products), demographic characteristics and treatment with the anti-retroviral drug zidovudine. Those factors "were not associated with the development of malignancy in HIV-infected children," the authors wrote.

The researchers did find a link between infection with the Epstein-Barr virus (EBV) and development of malignancy in the children, but only for children with CD4 cell counts above a specific level (CD4 cell count is one barometer of immune system response). There was no association between EBV and cancer risk in children with lower CD4 counts. "EBV cannot provide the sole explanation for the increased risk of cancer," the authors wrote.

Cancer is the leading medical cause of death in persons 15 and younger, and nearly 15,000 cases are reported annually in persons 20 and younger. Only 183 out of 1 million children age 20 and younger will be diagnosed with cancer, but the rate is much higher in AIDS-affected children. For example, AIDS-affected children run more than 650 times the risk of developing non-Hodgkin lymphoma than those without AIDS.1

Dr. Pollock is professor of pediatrics and medicine at the Health Science Center and director of the university's Center for Epidemiology and Biostatistics. His co-authors from the Health Science Center are Sharon B. Murphy, M.D., professor of pediatrics and director of the Children's Cancer Research Institute, and Charles T. Leach, M.D., professor of pediatrics. Dr. Murphy headed the Pediatric Oncology Group from 1993 to 2001. Co-authors from other institutions are Richard T. Parmley, M.D., and Hal B. Jenson, M.D., both former Health Science Center faculty members; Kenneth L. McClain, M.D., Ph.D.; Robert E. Hutchison, M.D.; Linda Garzarella, M.S.; and Vijay V. Joshi, M.D.

1Biggar RJ, Frisch M, Goedert JJ: Risk of cancer in children with AIDS. JAMA 284(2):205-209, 2000.

Contact: Will Sansom