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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2009 > November
More non-AIDS-defining malignancies among HIV-infected patients
Last Updated: 2009-11-06 14:59:34 -0400 (Reuters Health)
NEW YORK (Reuters Health) - HIV-infected patients have a higher-than-average incidence of non-AIDS-defining malignancies, according to a report in the October 1st Journal of Acquired Immune Deficiency Syndromes.
Their rates of certain non-AIDS-defining malignancies - that is, cancers not associated with immunosuppression - are believed to have increased since the introduction of highly active antiretroviral therapy (HAART), but according to the authors of the report, incidences in HIV-positive patients and uninfected patients have not been compared until now.
Dr. Roger J. Bedimo from the University of Texas Southwestern Medical Center, Dallas, and colleagues used U.S. Veterans Affairs Healthcare System data from 1997 through 2004 to analyze rates of non-AIDS-defining malignancies in 33,420 HIV-infected patients and 66,840 matched controls. Median follow-up periods were roughly 5 and 6 years for infected and uninfected subjects, respectively.
HIV-infected patients were more likely than controls to have melanoma, Hodgkin's lymphoma, or anal, lung, or liver cancer, the authors report, whereas the likelihood of prostate cancer was similar between the 2 groups.
Overall, the incidence of non-AIDS-defining malignancies per 100,000 person-years was 1260 in HIV-infected patients and 841 in controls, the report indicates, yielding an incidence rate ratio of 1.6. The incidence rate ratio was highest for anal cancer, at 14.9.
Among HIV-infected patients, median CD4 counts were lower in those with non-AIDS-defining malignancies in general and for individuals with anal cancer and Hodgkin lymphoma in particular. Prostate cancer, however, was linked with a higher CD4 count.
"These trends warrant a high index of suspicion for malignancies among HIV providers and a renewed focus on understanding the mechanisms underlying the increased rates," the investigators conclude.
J Acquir Immune Defic Syndr 2009;52:203-208.
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