Assessing cancer-related mortality risk among people with HIV in Vietnam: A nationwide population study.

[BACKGROUND] Despite the growing burden of comorbidities, including cancer, among people with HIV, there is a lack of empirical evidence on cancer-related mortality in this vulnerable population in Vietnam.

[OBJECTIVES] This study aimed to examine cancer mortality rates among people with HIV in Vietnam by cancer type, age and sex and compare them with those in the general population.

[METHODS] We analysed nationally representative mortality data from 2005 to 2021, collected via Vietnam's mandatory mortality registration system. Cancer deaths and HIV status were identified using the ICD-10 codes. People with HIV data were linked to the Vietnam Ministry of Health HIV/AIDS registry. Mortality rates (per 100 000 person-years) and mortality rate ratios (MRRs) with 95% confidence intervals (CIs) were calculated, stratified by age and sex and age-standardized using the World Health Organization standards.

[RESULTS] Among people with HIV, 253 cancer deaths occurred across 523709 person-years (crude rate 48.3 per 100 000 person-years), compared to 173 592 cancer deaths over 272 million person-years in the general population (crude rate 63.8 per 100 000 person-years) between 2005 and 2021. The age-standardized cancer mortality rate among people with HIV was 50.5 per 100 000 person-years, compared with 110.2 per 100 000 person-years in the general population. However, age-specific analysis revealed that cancer mortality rates among people with HIV under age 50 were significantly higher than those in the general population (MRR = 2.29; 95% CI: 2.01-2.59), predominantly for lung cancer (MRR = 10.5; 95% CI: 8.89, 12.41) and liver cancer (MRR = 1.82; 95% CI: 1.38, 2.40). The highest MRR was observed in the youngest age group (1-29 years; MRR = 5.67; 95% CI: 4.63, 6.93).

[CONCLUSION] Although the age-standardized cancer mortality rate among people with HIV was lower than in the general population, people with HIV experience substantially higher cancer mortality among those under age 50, particularly from lung and liver cancers. These findings emphasize the urgent need for integrated cancer prevention, early detection and treatment strategies for people with HIV in Vietnam.