Incidence of AIDS‐defining cancers and virus‐related and non‐virus‐related non‐AIDS‐defining cancers among HIV‐infected patients compared with the general population in a large health district of northern Italy, 1999–2009

Objectives The aim of the study was to investigate the incidence of AIDS‐defining cancers (ADCs) and virus‐related and non‐virus‐related non‐AIDS‐defining cancers (NADCs) in HIV‐infected patients compared with the general population, and to assess the risk factors associated with these malignancies....

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Published in:HIV medicine 2013-09, Vol.14 (8), p.481-490
Main Authors: Calabresi, A, Ferraresi, A, Festa, A, Scarcella, C, Donato, F, Vassallo, F, Limina, RM, Castelli, F, Quiros‐Roldan, E
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Adult
Age
Age Factors
Aged
cancer
CD4 Lymphocyte Count
cohort
Cohort Studies
Comorbidity
Female
HIV Infections - epidemiology
HIV/AIDS
Hodgkin Disease - epidemiology
Human immunodeficiency virus
Humans
incidence
Italy - epidemiology
Lymphoma, AIDS-Related - epidemiology
Male
Middle Aged
Neoplasms - epidemiology
Poisson Distribution
Regression Analysis
Retrospective Studies
Risk Factors
Sarcoma, Kaposi - epidemiology
Young Adult
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Summary:Objectives The aim of the study was to investigate the incidence of AIDS‐defining cancers (ADCs) and virus‐related and non‐virus‐related non‐AIDS‐defining cancers (NADCs) in HIV‐infected patients compared with the general population, and to assess the risk factors associated with these malignancies. Methods We performed a retrospective cohort study for the period from 1999 to 2009 of HIV‐infected patients residing in the Local Health Authority of Brescia (northern Italy). Observed cancers in patients with HIV infection were compared with expected cancers in the population living in the same area using standardized incidence ratios (SIRs). Risk factors were assessed using Poisson regression analysis. Results A total of 5090 HIV‐infected patients were included in the study, with 32 390 person‐years of follow‐up. We recorded 416 tumours in 390 HIV‐infected patients. Two hundred of these (48.1%) were ADCs, 138 (33.2%) were non‐virus‐related NADCs and 78 (18.7%) were virus‐related NADCs. An increased risk (SIR = 4.2) of cancers overall was found in HIV‐infected patients. A large excess of ADCs (SIR = 31.0) and virus‐related NADCs (SIR = 12.3) was observed in HIV‐infected patients, while the excess risk for non‐virus‐related NADCs was small (SIR = 1.6). The highest SIRs were observed for Kaposi sarcoma among ADCs and for Hodgkin lymphoma among virus‐related NADCs. Conversely, among non‐virus‐related NADCs, SIRs for a broad range of malignancies were close to unity. In multivariate analysis, increasing age and CD4 cell count
ISSN:1464-2662
1468-1293
DOI:10.1111/hiv.12034