{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T20:54:09Z","timestamp":1778964849365,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T00:00:00Z","timestamp":1585008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"United States National Institutes of Health","award":["D43 TW009744"],"award-info":[{"award-number":["D43 TW009744"]}]},{"name":"U.S. Civilian Research & Development Foundation","award":["DAA3-16-62699-1"],"award-info":[{"award-number":["DAA3-16-62699-1"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The human immunodeficiency virus (HIV) pandemic heavily affects sub\u2010Saharan Africa. It is associated with persistently active Epstein\u2010Barr virus (EBV) infection. To determine if this translates into increased frequency of EBV\u2010associated gastric cancer (EBVaGC), we evaluated molecular profiles of gastric cancer (GC) in Zambia. Patients with GC or premalignant gastric lesions were enrolled in Lusaka, Zambia. We used patients without any of these lesions as a control group. Chromogenic in situ hybridization (CISH) on tumor tissue was used to identify EBVaGC. To identify the microsatellite unstable subtype, immunofluorescence staining for MutL homolog 1 (MLH1) was used. Exposure to EBV and HIV was assessed serologically. We enrolled 369 patients (median age 52\u00a0years [IQR 41\u201065]; 198 (54%) female). Of these, 72 (20%) had GC and 35 (9%) had gastric premalignant lesions (PL). CISH identified EBVaGC in 5\/44 (11%) of those with adequate tissue, while MLH1 loss was identified in 29\/45 (64%). Both GC and PL were associated with the highest titers of antibodies to Early antigen\u2010diffuse (OR 2.5, 95% CI 1.0\u20106.1, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.048 and OR 3.9, 95% CI 1.1\u201012.9, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03, respectively) at high concentrations. Human immunodeficiency virus infection was associated with a range of antibodies to EBV, but not with any cancer subtype. Despite the association of HIV with persistent EBV, the proportion of EBVaGC in Zambia is similar to populations with a low prevalence of HIV infection. The proportion of microsatellite unstable tumors may be higher than other populations.<\/jats:p>","DOI":"10.1002\/cam4.3001","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T07:55:46Z","timestamp":1585036546000},"page":"3445-3454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Molecular profiling of gastric cancer in a population with high HIV prevalence reveals a shift to MLH1 loss but not the EBV subtype"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6521-2501","authenticated-orcid":false,"given":"Violet","family":"Kayamba","sequence":"first","affiliation":[{"name":"Tropical Gastroenterology &amp; Nutrition Group Department of Internal Medicine Lusaka Zambia"},{"name":"University of Zambia School of Medicine Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Butt","sequence":"additional","affiliation":[{"name":"Cancer Control and Population Sciences Program Duke Cancer Institute Duke University Durham NC USA"},{"name":"Department of Population Health Sciences Duke University Durham NC USA"},{"name":"Infection and Cancer Epidemiology Group German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Waterboer","sequence":"additional","affiliation":[{"name":"Infection and Cancer Epidemiology Group German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Besa","sequence":"additional","affiliation":[{"name":"Tropical Gastroenterology &amp; Nutrition Group Department of Internal Medicine Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naheed","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Blizard Institute Barts &amp; The London School of Medicine and Dentistry Queen Mary University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anglin","family":"Hamasuku","sequence":"additional","affiliation":[{"name":"University Teaching Hospital Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Julius","sequence":"additional","affiliation":[{"name":"University of Zambia School of Medicine Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas C.","family":"Heimburger","sequence":"additional","affiliation":[{"name":"Vanderbilt Institute for Global Health and Department of Medicine Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masharip","family":"Atadzhanov","sequence":"additional","affiliation":[{"name":"University of Zambia School of Medicine Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kelly","sequence":"additional","affiliation":[{"name":"Tropical Gastroenterology &amp; Nutrition Group Department of Internal Medicine Lusaka Zambia"},{"name":"University of Zambia School of Medicine Lusaka Zambia"},{"name":"Blizard Institute Barts &amp; The London School of Medicine and Dentistry Queen Mary University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"13","article-title":"Gastric malignancy survival in Zambia, Southern Africa: a two year follow up 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