Risk of non-AIDS-defining cancers among HIV-1-infected individuals in France between 1997 and 2009: results from a French cohort
Improved survival among HIV-infected individuals after the advent of combination antiretroviral therapy (cART) had drawn attention on non-AIDS-defining cancers. We evaluated the incidence and risk trends of lung cancer, Hodgkin's lymphoma, liver and anal cancers, focusing on patients with CD4 c...
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| Veröffentlicht in: | AIDS (London) 2014-09, Vol.28 (14), p.2109-2118 |
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| creator | Hleyhel, Mira Hleyhel, Mira Bouvier, Anne Marie Belot, Aurélien Tattevin, Pierre Pacanowski, Jérôme Genet, Philippe De Castro, Nathalie Berger, Jean-Luc Dupont, Caroline Lavolé, Armelle Pradier, Christian Salmon, Dominique Simon, Anne Martinez, Valérie Spano, Jean Philippe Costagliola, Dominique Grabar, Sophie |
| description | Improved survival among HIV-infected individuals after the advent of combination antiretroviral therapy (cART) had drawn attention on non-AIDS-defining cancers. We evaluated the incidence and risk trends of lung cancer, Hodgkin's lymphoma, liver and anal cancers, focusing on patients with CD4 cell recovery and age at diagnosis, by comparison with the general population.
Cohort study.
Standardized incidence rates were calculated in the HIV-infected individuals followed in the FHDH and the general population in France in 1997-2000, 2001-2004, and 2005-2009. We estimated standardized incidence ratios for each period and for patients with CD4 cell count at least 500 cells/μl for at least 2 years on cART.
Among the 84,504 HIV-infected individuals, the risk of lung and anal cancers fell during the cART era, whereas that of Hodgkin's lymphoma and liver cancer remained stable. In 2005-2009, the standardized incidence ratios for lung cancer, Hodgkin's lymphoma, liver and anal cancers were, respectively, 2.8 [95% confidence interval (CI) 2.5-3.1], 26.5 (95% CI 23.2-30.1), 10.9 (95% CI 9.6-12.3) and 79.3 (95% CI 69.5-90.1). Among patients with CD4 cell recovery on cART, the risk was close to that of the general population for lung cancer, nine-fold higher for Hodgkin's lymphoma, and 2.4-fold higher for liver cancer. Age at diagnosis was significantly younger among HIV-infected individuals for lung cancer (-3.3 years), Hodgkin's lymphoma (-1 year) and liver cancer (-10.1 years).
HIV-infected patients were at a higher risk for the four cancers over 1997-2009. CD4 cell recovery appears to control the excess risk of lung cancer. For liver cancer and Hodgkin's lymphoma, our results suggest that CD4 should never drop below 500/μl 500 cells/μl to avoid the excess risk. |
| doi_str_mv | 10.1097/QAD.0000000000000382 |
| format | Article |
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Cohort study.
Standardized incidence rates were calculated in the HIV-infected individuals followed in the FHDH and the general population in France in 1997-2000, 2001-2004, and 2005-2009. We estimated standardized incidence ratios for each period and for patients with CD4 cell count at least 500 cells/μl for at least 2 years on cART.
Among the 84,504 HIV-infected individuals, the risk of lung and anal cancers fell during the cART era, whereas that of Hodgkin's lymphoma and liver cancer remained stable. In 2005-2009, the standardized incidence ratios for lung cancer, Hodgkin's lymphoma, liver and anal cancers were, respectively, 2.8 [95% confidence interval (CI) 2.5-3.1], 26.5 (95% CI 23.2-30.1), 10.9 (95% CI 9.6-12.3) and 79.3 (95% CI 69.5-90.1). Among patients with CD4 cell recovery on cART, the risk was close to that of the general population for lung cancer, nine-fold higher for Hodgkin's lymphoma, and 2.4-fold higher for liver cancer. Age at diagnosis was significantly younger among HIV-infected individuals for lung cancer (-3.3 years), Hodgkin's lymphoma (-1 year) and liver cancer (-10.1 years).
HIV-infected patients were at a higher risk for the four cancers over 1997-2009. CD4 cell recovery appears to control the excess risk of lung cancer. For liver cancer and Hodgkin's lymphoma, our results suggest that CD4 should never drop below 500/μl 500 cells/μl to avoid the excess risk.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0000000000000382</identifier><identifier>PMID: 25265077</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; AIDS/HIV ; Anti-HIV Agents - therapeutic use ; Antiretroviral Therapy, Highly Active ; Anus Neoplasms - immunology ; Anus Neoplasms - mortality ; CD4 Lymphocyte Count ; Cohort Studies ; Female ; Follow-Up Studies ; France - epidemiology ; HIV Infections - immunology ; HIV Infections - mortality ; Hodgkin Disease - immunology ; Hodgkin Disease - mortality ; Human immunodeficiency virus ; Humans ; Incidence ; Lentivirus ; Liver Neoplasms - immunology ; Liver Neoplasms - mortality ; Lung Neoplasms - immunology ; Lung Neoplasms - mortality ; Male ; Retroviridae ; Risk Factors ; Survival Analysis</subject><ispartof>AIDS (London), 2014-09, Vol.28 (14), p.2109-2118</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c289t-6c899d8288af52b89896e1331dd354fd1a89b00fb59a5ba300ed27b8ee0578f23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25265077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hleyhel, Mira</creatorcontrib><creatorcontrib>Hleyhel, Mira</creatorcontrib><creatorcontrib>Bouvier, Anne Marie</creatorcontrib><creatorcontrib>Belot, Aurélien</creatorcontrib><creatorcontrib>Tattevin, Pierre</creatorcontrib><creatorcontrib>Pacanowski, Jérôme</creatorcontrib><creatorcontrib>Genet, Philippe</creatorcontrib><creatorcontrib>De Castro, Nathalie</creatorcontrib><creatorcontrib>Berger, Jean-Luc</creatorcontrib><creatorcontrib>Dupont, Caroline</creatorcontrib><creatorcontrib>Lavolé, Armelle</creatorcontrib><creatorcontrib>Pradier, Christian</creatorcontrib><creatorcontrib>Salmon, Dominique</creatorcontrib><creatorcontrib>Simon, Anne</creatorcontrib><creatorcontrib>Martinez, Valérie</creatorcontrib><creatorcontrib>Spano, Jean Philippe</creatorcontrib><creatorcontrib>Costagliola, Dominique</creatorcontrib><creatorcontrib>Grabar, Sophie</creatorcontrib><creatorcontrib>Cancer Risk Group of the French Hospital Database on HIV (FHDH-ANRS CO4)</creatorcontrib><title>Risk of non-AIDS-defining cancers among HIV-1-infected individuals in France between 1997 and 2009: results from a French cohort</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>Improved survival among HIV-infected individuals after the advent of combination antiretroviral therapy (cART) had drawn attention on non-AIDS-defining cancers. We evaluated the incidence and risk trends of lung cancer, Hodgkin's lymphoma, liver and anal cancers, focusing on patients with CD4 cell recovery and age at diagnosis, by comparison with the general population.
Cohort study.
Standardized incidence rates were calculated in the HIV-infected individuals followed in the FHDH and the general population in France in 1997-2000, 2001-2004, and 2005-2009. We estimated standardized incidence ratios for each period and for patients with CD4 cell count at least 500 cells/μl for at least 2 years on cART.
Among the 84,504 HIV-infected individuals, the risk of lung and anal cancers fell during the cART era, whereas that of Hodgkin's lymphoma and liver cancer remained stable. In 2005-2009, the standardized incidence ratios for lung cancer, Hodgkin's lymphoma, liver and anal cancers were, respectively, 2.8 [95% confidence interval (CI) 2.5-3.1], 26.5 (95% CI 23.2-30.1), 10.9 (95% CI 9.6-12.3) and 79.3 (95% CI 69.5-90.1). Among patients with CD4 cell recovery on cART, the risk was close to that of the general population for lung cancer, nine-fold higher for Hodgkin's lymphoma, and 2.4-fold higher for liver cancer. Age at diagnosis was significantly younger among HIV-infected individuals for lung cancer (-3.3 years), Hodgkin's lymphoma (-1 year) and liver cancer (-10.1 years).
HIV-infected patients were at a higher risk for the four cancers over 1997-2009. CD4 cell recovery appears to control the excess risk of lung cancer. 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Hleyhel, Mira ; Bouvier, Anne Marie ; Belot, Aurélien ; Tattevin, Pierre ; Pacanowski, Jérôme ; Genet, Philippe ; De Castro, Nathalie ; Berger, Jean-Luc ; Dupont, Caroline ; Lavolé, Armelle ; Pradier, Christian ; Salmon, Dominique ; Simon, Anne ; Martinez, Valérie ; Spano, Jean Philippe ; Costagliola, Dominique ; Grabar, Sophie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c289t-6c899d8288af52b89896e1331dd354fd1a89b00fb59a5ba300ed27b8ee0578f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Anus Neoplasms - immunology</topic><topic>Anus Neoplasms - mortality</topic><topic>CD4 Lymphocyte Count</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France - epidemiology</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - mortality</topic><topic>Hodgkin Disease - immunology</topic><topic>Hodgkin Disease - mortality</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lentivirus</topic><topic>Liver Neoplasms - immunology</topic><topic>Liver Neoplasms - mortality</topic><topic>Lung Neoplasms - immunology</topic><topic>Lung Neoplasms - mortality</topic><topic>Male</topic><topic>Retroviridae</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hleyhel, Mira</creatorcontrib><creatorcontrib>Hleyhel, Mira</creatorcontrib><creatorcontrib>Bouvier, Anne Marie</creatorcontrib><creatorcontrib>Belot, Aurélien</creatorcontrib><creatorcontrib>Tattevin, Pierre</creatorcontrib><creatorcontrib>Pacanowski, Jérôme</creatorcontrib><creatorcontrib>Genet, Philippe</creatorcontrib><creatorcontrib>De Castro, Nathalie</creatorcontrib><creatorcontrib>Berger, Jean-Luc</creatorcontrib><creatorcontrib>Dupont, Caroline</creatorcontrib><creatorcontrib>Lavolé, Armelle</creatorcontrib><creatorcontrib>Pradier, Christian</creatorcontrib><creatorcontrib>Salmon, Dominique</creatorcontrib><creatorcontrib>Simon, Anne</creatorcontrib><creatorcontrib>Martinez, Valérie</creatorcontrib><creatorcontrib>Spano, Jean Philippe</creatorcontrib><creatorcontrib>Costagliola, Dominique</creatorcontrib><creatorcontrib>Grabar, Sophie</creatorcontrib><creatorcontrib>Cancer Risk Group of the French Hospital Database on HIV (FHDH-ANRS CO4)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Safety Science and Risk</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hleyhel, Mira</au><au>Hleyhel, Mira</au><au>Bouvier, Anne Marie</au><au>Belot, Aurélien</au><au>Tattevin, Pierre</au><au>Pacanowski, Jérôme</au><au>Genet, Philippe</au><au>De Castro, Nathalie</au><au>Berger, Jean-Luc</au><au>Dupont, Caroline</au><au>Lavolé, Armelle</au><au>Pradier, Christian</au><au>Salmon, Dominique</au><au>Simon, Anne</au><au>Martinez, Valérie</au><au>Spano, Jean Philippe</au><au>Costagliola, Dominique</au><au>Grabar, Sophie</au><aucorp>Cancer Risk Group of the French Hospital Database on HIV (FHDH-ANRS CO4)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of non-AIDS-defining cancers among HIV-1-infected individuals in France between 1997 and 2009: results from a French cohort</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2014-09-10</date><risdate>2014</risdate><volume>28</volume><issue>14</issue><spage>2109</spage><epage>2118</epage><pages>2109-2118</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>Improved survival among HIV-infected individuals after the advent of combination antiretroviral therapy (cART) had drawn attention on non-AIDS-defining cancers. We evaluated the incidence and risk trends of lung cancer, Hodgkin's lymphoma, liver and anal cancers, focusing on patients with CD4 cell recovery and age at diagnosis, by comparison with the general population.
Cohort study.
Standardized incidence rates were calculated in the HIV-infected individuals followed in the FHDH and the general population in France in 1997-2000, 2001-2004, and 2005-2009. We estimated standardized incidence ratios for each period and for patients with CD4 cell count at least 500 cells/μl for at least 2 years on cART.
Among the 84,504 HIV-infected individuals, the risk of lung and anal cancers fell during the cART era, whereas that of Hodgkin's lymphoma and liver cancer remained stable. In 2005-2009, the standardized incidence ratios for lung cancer, Hodgkin's lymphoma, liver and anal cancers were, respectively, 2.8 [95% confidence interval (CI) 2.5-3.1], 26.5 (95% CI 23.2-30.1), 10.9 (95% CI 9.6-12.3) and 79.3 (95% CI 69.5-90.1). Among patients with CD4 cell recovery on cART, the risk was close to that of the general population for lung cancer, nine-fold higher for Hodgkin's lymphoma, and 2.4-fold higher for liver cancer. Age at diagnosis was significantly younger among HIV-infected individuals for lung cancer (-3.3 years), Hodgkin's lymphoma (-1 year) and liver cancer (-10.1 years).
HIV-infected patients were at a higher risk for the four cancers over 1997-2009. CD4 cell recovery appears to control the excess risk of lung cancer. For liver cancer and Hodgkin's lymphoma, our results suggest that CD4 should never drop below 500/μl 500 cells/μl to avoid the excess risk.</abstract><cop>England</cop><pmid>25265077</pmid><doi>10.1097/QAD.0000000000000382</doi><tpages>10</tpages></addata></record> |
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| ispartof | AIDS (London), 2014-09, Vol.28 (14), p.2109-2118 |
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| subjects | Adult AIDS/HIV Anti-HIV Agents - therapeutic use Antiretroviral Therapy, Highly Active Anus Neoplasms - immunology Anus Neoplasms - mortality CD4 Lymphocyte Count Cohort Studies Female Follow-Up Studies France - epidemiology HIV Infections - immunology HIV Infections - mortality Hodgkin Disease - immunology Hodgkin Disease - mortality Human immunodeficiency virus Humans Incidence Lentivirus Liver Neoplasms - immunology Liver Neoplasms - mortality Lung Neoplasms - immunology Lung Neoplasms - mortality Male Retroviridae Risk Factors Survival Analysis |
| title | Risk of non-AIDS-defining cancers among HIV-1-infected individuals in France between 1997 and 2009: results from a French cohort |
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