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Cancer, immunodeficiency and antiretroviral treatment: results from the Australian HIV O bservational D atabase ( AHOD )
Author(s) -
Petoumenos K,
van Leuwen MT,
Vajdic CM,
Woolley I,
Chuah J,
Templeton DJ,
Grulich AE,
Law MG
Publication year - 2013
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2012.01038.x
Subject(s) - medicine , cancer , cancer registry , anal cancer , confidence interval , lymphoma , cohort , incidence (geometry) , lung cancer , human immunodeficiency virus (hiv) , oncology , immunology , physics , optics
Objectives The objective of the study was to conduct a within‐cohort assessment of risk factors for incident AIDS ‐defining cancers ( ADC s) and non‐ ADC s ( NADC s) within the A ustralian HIV O bservational D atabase ( AHOD ). Methods A total of 2181 AHOD registrants were linked to the National AIDS Registry/National HIV Database ( NAR / NHD ) and the Australian Cancer Registry to identify those with a notified cancer diagnosis. Included in the current analyses were cancers diagnosed after HIV infection. Risk factors for cancers were also assessed using logistic regression methods. Results One hundred and thirty‐nine cancer cases were diagnosed after HIV infection among 129 patients. More than half the diagnoses ( n = 68; 60%) were ADC s, of which 69% were K aposi's sarcoma and 31% non‐ H odgkin's lymphoma. Among the NADC s, the most common cancers were melanoma ( n = 10), lung cancer ( n = 6), H odgkin's lymphoma ( n = 5) and anal cancer ( n = 5). Over a total of 21021 person‐years ( PY ) of follow‐up since HIV diagnosis, the overall crude cancer incidence rate for any cancer was 5.09/1000 PY . The overall rate of cancers decreased from 15.9/1000 PY [95% confidence interval ( CI ) 9.25–25.40/1000 PY ] for CD 4 counts < 100 cells/μL to 2.4/1000 PY (95% CI 1.62–3.39/1000 PY ) for CD 4 counts > 350 cells/μL. Lower CD 4 cell count and prior AIDS diagnoses were significant predictors for both ADC s and NADC s. Conclusions ADC s remain the predominant cancers in this population, although NADC rates have increased in the more recent time period. Immune deficiency is a risk factor for both ADC s and NADC s.