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Risk of AIDS-defining cancers among HIV-1-infected patients in France between 1992 and 2009: results from the FHDH-ANRS CO4 cohort. | LitMetric

AI Article Synopsis

  • The study analyzed trends in AIDS-defining cancers (Kaposi sarcoma, non-Hodgkin lymphoma, cervical cancer) among HIV-infected individuals in France from 1992 to 2009, comparing them to the general population.
  • Although the incidence of these cancers decreased over time, HIV-infected patients still faced a higher risk compared to the general population, especially for Kaposi sarcoma.
  • Patients on effective antiretroviral therapy tended to be diagnosed at a younger age, particularly for non-Hodgkin lymphoma, which was diagnosed about 11 years earlier than in the general population.

Article Abstract

Background: We examined trends in the incidence of the 3 AIDS-defining cancers (ADCs; Kaposi sarcoma [KS], non-Hodgkin lymphoma [NHL], and cervical cancer) among human immunodeficiency virus (HIV)-infected patients relative to the general population between 1992 and 2009 in France, focusing on age at ADC diagnosis and on patients with controlled viral load and restored immunity on combination antiretroviral therapy (cART).

Methods: Age- and sex-standardized incidence rates were estimated in patients enrolled in the French hospital database on HIV, and in the general population in France during 4 calendar periods (1992-1996, 1997-2000, 2001-2004, and 2005-2009). Standardized incidence ratios (SIRs) were calculated for all periods and separately for patients on cART, with CD4 counts ≥500 cells/µL for at least 2 years and viral load ≤500 copies/mL.

Results: Although the incidence of ADCs fell significantly across the calendar periods, the risk remained constantly higher in HIV-infected patients than in the general population. In patients with restored immunity, the relative risk remained significantly elevated for KS (SIR = 35.4; 95% confidence interval [CI], 18.3-61.9), and was similar to that of the general population for NHL (SIR = 1.0; 95% CI, .4-1.8). ADCs were diagnosed at a younger age in HIV-infected patients, with a particularly marked difference for NHL (-11.3 years, P < .0001).

Conclusions: The incidence of all ADCs continued to fall, including cervical cancer, in the cART period, but the risk remained higher than in the general population in 2005-2009. In patients with stably restored immunity, KS remained significantly more frequent than in the general population.

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Source
http://dx.doi.org/10.1093/cid/cit497DOI Listing

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