Cancer, immunodeficiency and antiretroviral treatment: results from the Australian HIV Observational Database (AHOD)
K Petoumenos, M T van Leuwen, C M Vajdic, I Woolley, J Chuah, D J Templeton, A E Grulich, M G Law, Australian HIV Observational Database, D Ellis, M Bloch, T Franic, S Agrawal, L McCann, N Cunningham, T Vincent, D Allen, J L Little, D Smith, C Gray, D Baker, R Vale, D J Templeton, C C O'Connor, C Dijanosic, E Jackson, K McCallum, M Grotowski, S Taylor, D Cooper, A Carr, F Lee, K Hesse, K Sinn, R Norris, R Finlayson, I Prone, E Jackson, J Shakeshaft, K Brown, C McGrath, V McGrath, S Halligan, L Wray, P Read, H Lu, D Couldwell, D Smith, V Furner, J Watson, C Lawrence, B Mulhall, M Law, K Petoumenos, S Wright, H McManus, C Bendall, M Boyd, A Kulatunga, P Knibbs, J Chuah, M Ngieng, B Dickson, D Russell, S Downing, D Sowden, J Broom, K Taing, C Johnston, K McGill, D Orth, D Youds, M Kelly, A Gibson, H Magon, W Donohue, R Moore, S Edwards, R Liddle, P Locke, N J Roth, J Nicolson, H Lau, T Read, J Silvers, W Zeng, J Hoy, K Watson, M Bryant, S Price, I Woolley, M Giles, T Korman, J Williams, D Nolan, J Skett, J Robinson, D Sowden, D J Templeton, J Hoy, L Wray, J Chuah, K Morwood, T Read, N Roth, I Woolley, M Kelly, J Broom, P C K Li, M P Lee, S Vanar, S Faridah, A Kamarulzaman, J Y Choi, B Vannary, R Ditangco, K Tsukada, S H Han, S Pujari, A Makane, O T Ng, A J Sasisopin, K Petoumenos, M T van Leuwen, C M Vajdic, I Woolley, J Chuah, D J Templeton, A E Grulich, M G Law, Australian HIV Observational Database, D Ellis, M Bloch, T Franic, S Agrawal, L McCann, N Cunningham, T Vincent, D Allen, J L Little, D Smith, C Gray, D Baker, R Vale, D J Templeton, C C O'Connor, C Dijanosic, E Jackson, K McCallum, M Grotowski, S Taylor, D Cooper, A Carr, F Lee, K Hesse, K Sinn, R Norris, R Finlayson, I Prone, E Jackson, J Shakeshaft, K Brown, C McGrath, V McGrath, S Halligan, L Wray, P Read, H Lu, D Couldwell, D Smith, V Furner, J Watson, C Lawrence, B Mulhall, M Law, K Petoumenos, S Wright, H McManus, C Bendall, M Boyd, A Kulatunga, P Knibbs, J Chuah, M Ngieng, B Dickson, D Russell, S Downing, D Sowden, J Broom, K Taing, C Johnston, K McGill, D Orth, D Youds, M Kelly, A Gibson, H Magon, W Donohue, R Moore, S Edwards, R Liddle, P Locke, N J Roth, J Nicolson, H Lau, T Read, J Silvers, W Zeng, J Hoy, K Watson, M Bryant, S Price, I Woolley, M Giles, T Korman, J Williams, D Nolan, J Skett, J Robinson, D Sowden, D J Templeton, J Hoy, L Wray, J Chuah, K Morwood, T Read, N Roth, I Woolley, M Kelly, J Broom, P C K Li, M P Lee, S Vanar, S Faridah, A Kamarulzaman, J Y Choi, B Vannary, R Ditangco, K Tsukada, S H Han, S Pujari, A Makane, O T Ng, A J Sasisopin
Abstract
Objectives: The objective of the study was to conduct a within-cohort assessment of risk factors for incident AIDS-defining cancers (ADCs) and non-ADCs (NADCs) within the Australian HIV Observational Database (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 ADCs, of which 69% were Kaposi's sarcoma and 31% non-Hodgkin's lymphoma. Among the NADCs, the most common cancers were melanoma (n = 10), lung cancer (n = 6), Hodgkin'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 CD4 counts < 100 cells/μL to 2.4/1000 PY (95% CI 1.62-3.39/1000 PY) for CD4 counts > 350 cells/μL. Lower CD4 cell count and prior AIDS diagnoses were significant predictors for both ADCs and NADCs.
Conclusions: ADCs 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 ADCs and NADCs.
© 2012 British HIV Association.
Figures
Source: PubMed