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HIV Infection and Survival Among Women With Cervical Cancer

Identifieur interne : 001694 ( Pmc/Corpus ); précédent : 001693; suivant : 001695

HIV Infection and Survival Among Women With Cervical Cancer

Auteurs : Scott Dryden-Peterson ; Memory Bvochora-Nsingo ; Gita Suneja ; Jason A. Efstathiou ; Surbhi Grover ; Sebathu Chiyapo ; Doreen Ramogola-Masire ; Malebogo Kebabonye-Pusoentsi ; Rebecca Clayman ; Abigail C. Mapes ; Neo Tapela ; Aida Asmelash ; Heluf Medhin ; Akila N. Viswanathan ; Anthony H. Russell ; Lilie L. Lin ; Mukendi K. A. Kayembe ; Mompati Mmalane ; Thomas C. Randall ; Bruce Chabner ; Shahin Lockman

Source :

RBID : PMC:5477924

Abstract

Purpose

Cervical cancer is the leading cause of cancer death among the 20 million women with HIV worldwide. We sought to determine whether HIV infection affected survival in women with invasive cervical cancer.

Patients and Methods

We enrolled sequential patients with cervical cancer in Botswana from 2010 to 2015. Standard treatment included external beam radiation and brachytherapy with concurrent cisplatin chemotherapy. The effect of HIV on survival was estimated by using an inverse probability weighted marginal Cox model.

Results

A total of 348 women with cervical cancer were enrolled, including 231 (66.4%) with HIV and 96 (27.6%) without HIV. The majority (189 [81.8%]) of women with HIV received antiretroviral therapy before cancer diagnosis. The median CD4 cell count for women with HIV was 397 (interquartile range, 264 to 555). After a median follow-up of 19.7 months, 117 (50.7%) women with HIV and 40 (41.7%) without HIV died. One death was attributed to HIV and the remaining to cancer. Three-year survival for the women with HIV was 35% (95% CI, 27% to 44%) and 48% (95% CI, 35% to 60%) for those without HIV. In an adjusted analysis, HIV infection significantly increased the risk for death among all women (hazard ratio, 1.95; 95% CI, 1.20 to 3.17) and in the subset that received guideline-concordant curative treatment (hazard ratio, 2.63; 95% CI, 1.05 to 6.55). The adverse effect of HIV on survival was greater for women with a more-limited stage cancer (P = .035), those treated with curative intent (P = .003), and those with a lower CD4 cell count (P = .036). Advanced stage and poor treatment completion contributed to high mortality overall.

Conclusion

In the context of good access to and use of antiretroviral treatment in Botswana, HIV infection significantly decreases cervical cancer survival.


Url:
DOI: 10.1200/JCO.2016.67.9613
PubMed: 27573661
PubMed Central: 5477924

Links to Exploration step

PMC:5477924

Le document en format XML

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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
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<name sortKey="Bvochora Nsingo, Memory" sort="Bvochora Nsingo, Memory" uniqKey="Bvochora Nsingo M" first="Memory" last="Bvochora-Nsingo">Memory Bvochora-Nsingo</name>
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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
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<name sortKey="Suneja, Gita" sort="Suneja, Gita" uniqKey="Suneja G" first="Gita" last="Suneja">Gita Suneja</name>
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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
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<name sortKey="Efstathiou, Jason A" sort="Efstathiou, Jason A" uniqKey="Efstathiou J" first="Jason A." last="Efstathiou">Jason A. Efstathiou</name>
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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
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<name sortKey="Grover, Surbhi" sort="Grover, Surbhi" uniqKey="Grover S" first="Surbhi" last="Grover">Surbhi Grover</name>
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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chiyapo, Sebathu" sort="Chiyapo, Sebathu" uniqKey="Chiyapo S" first="Sebathu" last="Chiyapo">Sebathu Chiyapo</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
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<name sortKey="Ramogola Masire, Doreen" sort="Ramogola Masire, Doreen" uniqKey="Ramogola Masire D" first="Doreen" last="Ramogola-Masire">Doreen Ramogola-Masire</name>
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<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
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<author>
<name sortKey="Kebabonye Pusoentsi, Malebogo" sort="Kebabonye Pusoentsi, Malebogo" uniqKey="Kebabonye Pusoentsi M" first="Malebogo" last="Kebabonye-Pusoentsi">Malebogo Kebabonye-Pusoentsi</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
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<name sortKey="Clayman, Rebecca" sort="Clayman, Rebecca" uniqKey="Clayman R" first="Rebecca" last="Clayman">Rebecca Clayman</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mapes, Abigail C" sort="Mapes, Abigail C" uniqKey="Mapes A" first="Abigail C." last="Mapes">Abigail C. Mapes</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tapela, Neo" sort="Tapela, Neo" uniqKey="Tapela N" first="Neo" last="Tapela">Neo Tapela</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Asmelash, Aida" sort="Asmelash, Aida" uniqKey="Asmelash A" first="Aida" last="Asmelash">Aida Asmelash</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Medhin, Heluf" sort="Medhin, Heluf" uniqKey="Medhin H" first="Heluf" last="Medhin">Heluf Medhin</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Viswanathan, Akila N" sort="Viswanathan, Akila N" uniqKey="Viswanathan A" first="Akila N." last="Viswanathan">Akila N. Viswanathan</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Russell, Anthony H" sort="Russell, Anthony H" uniqKey="Russell A" first="Anthony H." last="Russell">Anthony H. Russell</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lin, Lilie L" sort="Lin, Lilie L" uniqKey="Lin L" first="Lilie L." last="Lin">Lilie L. Lin</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kayembe, Mukendi K A" sort="Kayembe, Mukendi K A" uniqKey="Kayembe M" first="Mukendi K. A." last="Kayembe">Mukendi K. A. Kayembe</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mmalane, Mompati" sort="Mmalane, Mompati" uniqKey="Mmalane M" first="Mompati" last="Mmalane">Mompati Mmalane</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Randall, Thomas C" sort="Randall, Thomas C" uniqKey="Randall T" first="Thomas C." last="Randall">Thomas C. Randall</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chabner, Bruce" sort="Chabner, Bruce" uniqKey="Chabner B" first="Bruce" last="Chabner">Bruce Chabner</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lockman, Shahin" sort="Lockman, Shahin" uniqKey="Lockman S" first="Shahin" last="Lockman">Shahin Lockman</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
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<idno type="doi">10.1200/JCO.2016.67.9613</idno>
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<title xml:lang="en" level="a" type="main">HIV Infection and Survival Among Women With Cervical Cancer</title>
<author>
<name sortKey="Dryden Peterson, Scott" sort="Dryden Peterson, Scott" uniqKey="Dryden Peterson S" first="Scott" last="Dryden-Peterson">Scott Dryden-Peterson</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bvochora Nsingo, Memory" sort="Bvochora Nsingo, Memory" uniqKey="Bvochora Nsingo M" first="Memory" last="Bvochora-Nsingo">Memory Bvochora-Nsingo</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Suneja, Gita" sort="Suneja, Gita" uniqKey="Suneja G" first="Gita" last="Suneja">Gita Suneja</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Efstathiou, Jason A" sort="Efstathiou, Jason A" uniqKey="Efstathiou J" first="Jason A." last="Efstathiou">Jason A. Efstathiou</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Grover, Surbhi" sort="Grover, Surbhi" uniqKey="Grover S" first="Surbhi" last="Grover">Surbhi Grover</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chiyapo, Sebathu" sort="Chiyapo, Sebathu" uniqKey="Chiyapo S" first="Sebathu" last="Chiyapo">Sebathu Chiyapo</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ramogola Masire, Doreen" sort="Ramogola Masire, Doreen" uniqKey="Ramogola Masire D" first="Doreen" last="Ramogola-Masire">Doreen Ramogola-Masire</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kebabonye Pusoentsi, Malebogo" sort="Kebabonye Pusoentsi, Malebogo" uniqKey="Kebabonye Pusoentsi M" first="Malebogo" last="Kebabonye-Pusoentsi">Malebogo Kebabonye-Pusoentsi</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Clayman, Rebecca" sort="Clayman, Rebecca" uniqKey="Clayman R" first="Rebecca" last="Clayman">Rebecca Clayman</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mapes, Abigail C" sort="Mapes, Abigail C" uniqKey="Mapes A" first="Abigail C." last="Mapes">Abigail C. Mapes</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tapela, Neo" sort="Tapela, Neo" uniqKey="Tapela N" first="Neo" last="Tapela">Neo Tapela</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Asmelash, Aida" sort="Asmelash, Aida" uniqKey="Asmelash A" first="Aida" last="Asmelash">Aida Asmelash</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Medhin, Heluf" sort="Medhin, Heluf" uniqKey="Medhin H" first="Heluf" last="Medhin">Heluf Medhin</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Viswanathan, Akila N" sort="Viswanathan, Akila N" uniqKey="Viswanathan A" first="Akila N." last="Viswanathan">Akila N. Viswanathan</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Russell, Anthony H" sort="Russell, Anthony H" uniqKey="Russell A" first="Anthony H." last="Russell">Anthony H. Russell</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lin, Lilie L" sort="Lin, Lilie L" uniqKey="Lin L" first="Lilie L." last="Lin">Lilie L. Lin</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kayembe, Mukendi K A" sort="Kayembe, Mukendi K A" uniqKey="Kayembe M" first="Mukendi K. A." last="Kayembe">Mukendi K. A. Kayembe</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mmalane, Mompati" sort="Mmalane, Mompati" uniqKey="Mmalane M" first="Mompati" last="Mmalane">Mompati Mmalane</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Randall, Thomas C" sort="Randall, Thomas C" uniqKey="Randall T" first="Thomas C." last="Randall">Thomas C. Randall</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chabner, Bruce" sort="Chabner, Bruce" uniqKey="Chabner B" first="Bruce" last="Chabner">Bruce Chabner</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Lockman, Shahin" sort="Lockman, Shahin" uniqKey="Lockman S" first="Shahin" last="Lockman">Shahin Lockman</name>
<affiliation>
<nlm:aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Journal of Clinical Oncology</title>
<idno type="ISSN">0732-183X</idno>
<idno type="eISSN">1527-7755</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Purpose</title>
<p>Cervical cancer is the leading cause of cancer death among the 20 million women with HIV worldwide. We sought to determine whether HIV infection affected survival in women with invasive cervical cancer.</p>
</sec>
<sec>
<title>Patients and Methods</title>
<p>We enrolled sequential patients with cervical cancer in Botswana from 2010 to 2015. Standard treatment included external beam radiation and brachytherapy with concurrent cisplatin chemotherapy. The effect of HIV on survival was estimated by using an inverse probability weighted marginal Cox model.</p>
</sec>
<sec>
<title>Results</title>
<p>A total of 348 women with cervical cancer were enrolled, including 231 (66.4%) with HIV and 96 (27.6%) without HIV. The majority (189 [81.8%]) of women with HIV received antiretroviral therapy before cancer diagnosis. The median CD4 cell count for women with HIV was 397 (interquartile range, 264 to 555). After a median follow-up of 19.7 months, 117 (50.7%) women with HIV and 40 (41.7%) without HIV died. One death was attributed to HIV and the remaining to cancer. Three-year survival for the women with HIV was 35% (95% CI, 27% to 44%) and 48% (95% CI, 35% to 60%) for those without HIV. In an adjusted analysis, HIV infection significantly increased the risk for death among all women (hazard ratio, 1.95; 95% CI, 1.20 to 3.17) and in the subset that received guideline-concordant curative treatment (hazard ratio, 2.63; 95% CI, 1.05 to 6.55). The adverse effect of HIV on survival was greater for women with a more-limited stage cancer (
<italic>P</italic>
= .035), those treated with curative intent (
<italic>P</italic>
= .003), and those with a lower CD4 cell count (
<italic>P</italic>
= .036). Advanced stage and poor treatment completion contributed to high mortality overall.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>In the context of good access to and use of antiretroviral treatment in Botswana, HIV infection significantly decreases cervical cancer survival.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Clin Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Clin. Oncol</journal-id>
<journal-id journal-id-type="hwp">jco</journal-id>
<journal-id journal-id-type="pmc">jco</journal-id>
<journal-id journal-id-type="publisher-id">JCO</journal-id>
<journal-title-group>
<journal-title>Journal of Clinical Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0732-183X</issn>
<issn pub-type="epub">1527-7755</issn>
<publisher>
<publisher-name>American Society of Clinical Oncology</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27573661</article-id>
<article-id pub-id-type="pmc">5477924</article-id>
<article-id pub-id-type="publisher-id">679613</article-id>
<article-id pub-id-type="doi">10.1200/JCO.2016.67.9613</article-id>
<article-categories>
<subj-group subj-group-type="subjects">
<subject>Radiation</subject>
<subject>Combined Modality</subject>
</subj-group>
<subj-group subj-group-type="heading">
<subject>ORIGINAL REPORTS</subject>
<subj-group>
<subject>AIDS-Related Cancer</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>HIV Infection and Survival Among Women With Cervical Cancer</article-title>
<alt-title alt-title-type="short">HIV and Cervical Cancer Survival</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Dryden-Peterson</surname>
<given-names>Scott</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bvochora-Nsingo</surname>
<given-names>Memory</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Suneja</surname>
<given-names>Gita</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Efstathiou</surname>
<given-names>Jason A.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Grover</surname>
<given-names>Surbhi</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chiyapo</surname>
<given-names>Sebathu</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ramogola-Masire</surname>
<given-names>Doreen</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kebabonye-Pusoentsi</surname>
<given-names>Malebogo</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Clayman</surname>
<given-names>Rebecca</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mapes</surname>
<given-names>Abigail C.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tapela</surname>
<given-names>Neo</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Asmelash</surname>
<given-names>Aida</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Medhin</surname>
<given-names>Heluf</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Viswanathan</surname>
<given-names>Akila N.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Russell</surname>
<given-names>Anthony H.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lin</surname>
<given-names>Lilie L.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kayembe</surname>
<given-names>Mukendi K.A.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mmalane</surname>
<given-names>Mompati</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Randall</surname>
<given-names>Thomas C.</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chabner</surname>
<given-names>Bruce</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lockman</surname>
<given-names>Shahin</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<aff id="aff1">Scott Dryden-Peterson, Akila N. Viswanathan, and Shahin Lockman, Brigham and Women’s Hospital; Scott Dryden-Peterson and Shahin Lockman, Harvard T.H. Chan School of Public Health; Scott Dryden-Peterson, Jason A. Efstathiou, Akila N. Viswanathan, Anthony H. Russell, Thomas C. Randall, Bruce Chabner, and Shahin Lockman, Harvard Medical School; Jason A. Efstathiou, Rebecca Clayman, Anthony H. Russell, Thomas C. Randall, and Bruce Chabner, Massachusetts General Hospital; Akila N. Viswanathan, Dana-Farber Cancer Institute, Boston, MA; Scott Dryden-Peterson, Abigail C. Mapes, Neo Tapela, Aida Asmelash, Mompati Mmalane, and Shahin Lockman, Botswana Harvard AIDS Institute Partnership; Memory Bvochora-Nsingo, Gaborone Private Hospital; Sebathu Chiyapo, Princess Marina Hospital; Doreen Ramogola-Masire, Botswana-University of Pennsylvania Partnership; Malebogo Kebabonye-Pusoentsi, Neo Tapela, Heluf Medhin, and Mukendi K.A. Kayembe, Botswana Ministry of Health, Gaborone, Botswana; Gita Suneja, University of Utah School of Medicine, Salt Lake City, UT; and Surbhi Grover and Lilie L. Lin, University of Pennsylvania, Philadelphia, PA.</aff>
</contrib-group>
<author-notes>
<corresp id="cor1">Corresponding author: Scott Dryden-Peterson, MD, Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115; e-mail:
<email>scott_peterson@post.harvard.edu</email>
.</corresp>
</author-notes>
<pub-date pub-type="ppub">
<day>1</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>29</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>1</day>
<month>5</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 6 months and 0 days and was based on the . </pmc-comment>
<volume>34</volume>
<issue>31</issue>
<fpage>3749</fpage>
<lpage>3757</lpage>
<permissions>
<copyright-statement>© 2016 by American Society of Clinical Oncology</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>American Society of Clinical Oncology</copyright-holder>
</permissions>
<self-uri content-type="pdf" xlink:title="pdf" xlink:href="JCO.2016.67.9613.pdf"></self-uri>
<abstract>
<sec>
<title>Purpose</title>
<p>Cervical cancer is the leading cause of cancer death among the 20 million women with HIV worldwide. We sought to determine whether HIV infection affected survival in women with invasive cervical cancer.</p>
</sec>
<sec>
<title>Patients and Methods</title>
<p>We enrolled sequential patients with cervical cancer in Botswana from 2010 to 2015. Standard treatment included external beam radiation and brachytherapy with concurrent cisplatin chemotherapy. The effect of HIV on survival was estimated by using an inverse probability weighted marginal Cox model.</p>
</sec>
<sec>
<title>Results</title>
<p>A total of 348 women with cervical cancer were enrolled, including 231 (66.4%) with HIV and 96 (27.6%) without HIV. The majority (189 [81.8%]) of women with HIV received antiretroviral therapy before cancer diagnosis. The median CD4 cell count for women with HIV was 397 (interquartile range, 264 to 555). After a median follow-up of 19.7 months, 117 (50.7%) women with HIV and 40 (41.7%) without HIV died. One death was attributed to HIV and the remaining to cancer. Three-year survival for the women with HIV was 35% (95% CI, 27% to 44%) and 48% (95% CI, 35% to 60%) for those without HIV. In an adjusted analysis, HIV infection significantly increased the risk for death among all women (hazard ratio, 1.95; 95% CI, 1.20 to 3.17) and in the subset that received guideline-concordant curative treatment (hazard ratio, 2.63; 95% CI, 1.05 to 6.55). The adverse effect of HIV on survival was greater for women with a more-limited stage cancer (
<italic>P</italic>
= .035), those treated with curative intent (
<italic>P</italic>
= .003), and those with a lower CD4 cell count (
<italic>P</italic>
= .036). Advanced stage and poor treatment completion contributed to high mortality overall.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>In the context of good access to and use of antiretroviral treatment in Botswana, HIV infection significantly decreases cervical cancer survival.</p>
</sec>
</abstract>
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