Herida M, Mary-Krause M, Kaphan R, Cadranel J, Poizot-Martin I, Rabaud C, Plaisance N, Tissot-Dupont H, Boue F, Lang JM, Costagliola D; Conference on Retroviruses and Opportunistic Infections; The Clinical Epidemiology Group from the French Hospital Database on HIV.
Abstr 10th Conf Retrovir Oppor Infect Feb 10 14 2003 Hynes Conv Cent Boston Mass USA Conf Retrovir Oppor Infect 10th 2003 Boston Mass. 2003 Feb 10-14; 10: abstract no. 818.
INSERM EMI 0214, Paris, France
BACKGROUND: To determine the incidence of non-AIDS defining cancers (NADC) in HIV-infected patients (pts) before and during the use of HAART, relative to that observed in the French general population of the same age and sex (FGP).METHODS: Sex- and age-adjusted NADC standardized incidence ratio (SIR), with FGP as reference, were estimated from a prospective hospital cohort study, the French Hospital Database on HIV in 1992-1995 (pre-HAART period = P1) and 1996-1999 (HAART period = P2).RESULTS: NADC were diagnosed in 260 pts during P1 and in 391 pts during P2 among the 77,025 subjects included in the database between 1 January 1992, and 31 December 1999. The estimated incidence of all cancers was higher in HIV-infected men than in FGP during both periods: P1 SIR = 2.33 (95% CI: 2.04-2.66) and P2 SIR = 1.89 (95% CI: 1.69-2.66), with the risk of colon-rectum-anus cancer higher in homosexual. No excess of cancers was observed among HIV-infected women in either period. The incidence of all cancers did not change from P1 to P2 in either sex: SIR=0.96 (95% CI: 0.86-1.26) for men and 1.00 (95% CI: 0.76-1.29) for women. In contrast, the incidence of Hodgkin's disease was higher than in FGP in both sexes and both periods (men: SIR = 22.75 [95% CI: 17.27-29.42] for P1 and SIR = 31.70 [95% CI: 25.82-38.52] for P2; women: SIR = 9.70 [95% CI: 3.13-22.63] for P1 and SIR = 14.38 [95% CI: 6.88-26.45] for P2), and the incidence of lung cancer was higher in both sexes during P2 (SIR = 2.12 [95% CI: 1.62-2.65] for men and SIR = 6.58 [95% CI: 3.40-11.56] for women).CONCLUSIONS: Relative to the French general population, the overall incidence of non AIDS-related malignancies was increased in HIV-infected men but not in women, and did not differ between the pre- and post-HAART eras. Hodgkin's disease was the only NADC with a significantly increased incidence relative to the general population, regardless of sex, the study period (pre- or post-HAART), or the transmission group (among men). Lung cancer was more frequent in both sexes during P2, and colon-rectum-anus cancers were more frequent in homosexual men; findings which are probably linked more to lifestyle factors and exposure to carcinogens than to HIV infection. This suggests that HIV-infected people with known risk factors for cancer, such as smoking, should receive special attention and advice on preventive measures.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- Anus Neoplasms
- Cohort Studies
- Female
- HIV Infections
- HIV Seropositivity
- Hodgkin Disease
- Humans
- Incidence
- Longitudinal Studies
- Male
- Neoplasms
- Prospective Studies
- Risk Factors
- epidemiology
Other ID:
UI: 102261468
From Meeting Abstracts