Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART Era

Impact of immunosuppression

Roger J. Bedimo, Kathleen A. McGinnis, Melinda Dunlap, Maria C. Rodriguez-Barradas, Amy C. Justice

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

BACKGROUND: The incidence of non-AIDS-defining malignancies (non-ADMs) is reported as unchanged or increasing in the highly active antiretroviral therapy era. Whether incidence of non-ADM is significantly higher in HIV-infected than in HIV-uninfected patients remains unclear. METHODS: Incidence rates of malignancies were calculated in a cohort of veterans in care for HIV-infected and age, race, and gender-matched uninfected patients from 1997 to 2004. For HIV-infected patients, CD4 counts closest to first observation date were compared between those with and without cancer. RESULTS: Thirty three thousand four hundred twenty HIV-infected and 66,840 HIV-uninfected patients were followed for a median of 5.1 and 6.4 years. The incidence rate ratio of HIV infected to HIV uninfected was 1.6 (1260 vs. 841 per 100,000 person-years; 95% confidence interval: 1.5 to 1.7). Incidence rate ratio for individual cancers was highest for anal cancer (14.9; confidence interval: 10.1 to 22.1). Among HIV-infected patients, median CD4 counts were lower for those with non-ADM (249 vs. 270, P = 0.02), anal cancer (156 vs. 270; P < 0.001), and Hodgkin lymphoma (217 vs. 269; P = 0.03). Prostate cancer was associated with a higher CD4 count (311 vs. 266; P < 0.001). CONCLUSIONS: In the highly active antiretroviral therapy era, the incidence of non-ADMs is higher among HIV-infected than HIV-uninfected patients, adjusting for age, race, and gender. Some non-ADMs do not seem to be associated with significantly lower CD4 counts.

Original languageEnglish (US)
Pages (from-to)203-208
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume52
Issue number2
DOIs
StatePublished - Oct 2009

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Highly Active Antiretroviral Therapy
Immunosuppression
HIV
Incidence
Neoplasms
CD4 Lymphocyte Count
Anus Neoplasms
Confidence Intervals
Veterans
Hodgkin Disease
Prostatic Neoplasms
Observation

Keywords

  • AIDS-defining malignancies
  • HAART
  • Incidence
  • Non-AIDS?defining malignancies

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART Era : Impact of immunosuppression. / Bedimo, Roger J.; McGinnis, Kathleen A.; Dunlap, Melinda; Rodriguez-Barradas, Maria C.; Justice, Amy C.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 52, No. 2, 10.2009, p. 203-208.

Research output: Contribution to journalArticle

Bedimo, Roger J. ; McGinnis, Kathleen A. ; Dunlap, Melinda ; Rodriguez-Barradas, Maria C. ; Justice, Amy C. / Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART Era : Impact of immunosuppression. In: Journal of Acquired Immune Deficiency Syndromes. 2009 ; Vol. 52, No. 2. pp. 203-208.
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abstract = "BACKGROUND: The incidence of non-AIDS-defining malignancies (non-ADMs) is reported as unchanged or increasing in the highly active antiretroviral therapy era. Whether incidence of non-ADM is significantly higher in HIV-infected than in HIV-uninfected patients remains unclear. METHODS: Incidence rates of malignancies were calculated in a cohort of veterans in care for HIV-infected and age, race, and gender-matched uninfected patients from 1997 to 2004. For HIV-infected patients, CD4 counts closest to first observation date were compared between those with and without cancer. RESULTS: Thirty three thousand four hundred twenty HIV-infected and 66,840 HIV-uninfected patients were followed for a median of 5.1 and 6.4 years. The incidence rate ratio of HIV infected to HIV uninfected was 1.6 (1260 vs. 841 per 100,000 person-years; 95{\%} confidence interval: 1.5 to 1.7). Incidence rate ratio for individual cancers was highest for anal cancer (14.9; confidence interval: 10.1 to 22.1). Among HIV-infected patients, median CD4 counts were lower for those with non-ADM (249 vs. 270, P = 0.02), anal cancer (156 vs. 270; P < 0.001), and Hodgkin lymphoma (217 vs. 269; P = 0.03). Prostate cancer was associated with a higher CD4 count (311 vs. 266; P < 0.001). CONCLUSIONS: In the highly active antiretroviral therapy era, the incidence of non-ADMs is higher among HIV-infected than HIV-uninfected patients, adjusting for age, race, and gender. Some non-ADMs do not seem to be associated with significantly lower CD4 counts.",
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