A role for ageing and HIV infection in HIV-related cancer risk

We read with interest the recent article by Crum-Cianflone et al. describing the independent predictors of incident AIDS-defining and non-AIDS-defining cancer in their multicenter, prospective natural history study of 4498 US military beneficiaries diagnosed with HIV between 1984 and 2006. Analyses were adjusted for year of HIV diagnosis and stratified by HIV diagnosis era (1996). Multivariate risk factors for non-AIDS-defining cancer (n= 135; most common cancer, nonmelanoma skin cancer n= 63) included increasing age at HIV diagnosis and white race; there was no association with latest CD4 cell count or HAART use. The authors concluded that the ageing of the HIV population was the primary factor associated with the rising rates of non-AIDS-defining cancer between the pre-HAART and post-HAART eras. Cumulative duration of immunosuppression was not assessed.