AI Article Synopsis
- The study analyzed survival rates and risk factors for HIV-infected individuals in Italy diagnosed with cancer, focusing on the differences between AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs).
- Findings showed better 10-year survival rates for ADCs (62.7%) compared to NADCs (46%), with specific cancers like non-Hodgkin lymphoma having notably lower survival compared to others like Kaposi sarcoma and cervical cancer.
- Factors such as low CD4+ counts and intravenous drug use were linked to poorer survival, while combined antiretroviral therapy (cART) improved outcomes for those with ADCs but not for those with NADCs.
Article Abstract
Objectives: We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC) or non-AIDS-defining cancer (NADC) diagnosis in the modern cART era.
Methods: Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model.
Results: Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51%) were ADCs and 431 (49%) were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017). Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001). Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14%) than lung cancer (1-year survival: 28%±8.7%), liver cancer (5-year survival: 31.9%±6.4%) or Hodgkin lymphoma (10-year survival: 24.8%±11.2%). Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs.
Conclusions: cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997420 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094768 | PLOS |
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