OBJECTIVE: To describe trends in incidence rates of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) during the HIV epidemic and to evaluate predictors, including the impact of antiretroviral therapy, of cancer development. DESIGN: Retrospective analysis of a multicenter, prospective natural history study including 4498 HIV-infected US military beneficiaries with 33 486 person-years of follow-up. METHODS: Predictors evaluated included demographics, clinical data, time-updated CD4 cell counts, HIV viral loads, and antiretroviral history. Time periods were classified as early pre (1984-1990), late pre (1991-1995), early post (1996-2000), and late post (2001-2006) HAART eras. Cox proportional hazard models were used to evaluate the association of specific factors with cancer. RESULTS: Ten percent of HIV-infected persons developed cancer. ADC rates increased between the early and late pre-HAART eras (7.6 and 14.2 cases per 1000 person-years) and have since declined from 5.4 to 2.7 in the early and late HAART eras, respectively (P < 0.001). Rates of NADCs have risen over the four periods (2.9, 2.8, 4.2, 6.7, P = 0.0004). During the late HAART era, 71% of cancers were NADCs. Predictors for ADCs included low CD4 cell count, noncancer AIDS diagnosis, and lack of HAART. NADCs were predicted by increasing age and white race (due to skin cancers). CONCLUSION: Although the rate of ADCs continues to fall, the rate of NADCs is rising and now accounts for the majority of cancers in HIV-infected persons. The development of NADCs is associated with increasing age among HIV patients. HAART use is protective for ADCs, but did not significantly impact NADCs.
OBJECTIVE: To describe trends in incidence rates of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) during the HIV epidemic and to evaluate predictors, including the impact of antiretroviral therapy, of cancer development. DESIGN: Retrospective analysis of a multicenter, prospective natural history study including 4498 HIV-infected US military beneficiaries with 33 486 person-years of follow-up. METHODS: Predictors evaluated included demographics, clinical data, time-updated CD4 cell counts, HIV viral loads, and antiretroviral history. Time periods were classified as early pre (1984-1990), late pre (1991-1995), early post (1996-2000), and late post (2001-2006) HAART eras. Cox proportional hazard models were used to evaluate the association of specific factors with cancer. RESULTS: Ten percent of HIV-infectedpersons developed cancer. ADC rates increased between the early and late pre-HAART eras (7.6 and 14.2 cases per 1000 person-years) and have since declined from 5.4 to 2.7 in the early and late HAART eras, respectively (P < 0.001). Rates of NADCs have risen over the four periods (2.9, 2.8, 4.2, 6.7, P = 0.0004). During the late HAART era, 71% of cancers were NADCs. Predictors for ADCs included low CD4 cell count, noncancer AIDS diagnosis, and lack of HAART. NADCs were predicted by increasing age and white race (due to skin cancers). CONCLUSION: Although the rate of ADCs continues to fall, the rate of NADCs is rising and now accounts for the majority of cancers in HIV-infectedpersons. The development of NADCs is associated with increasing age among HIVpatients. HAART use is protective for ADCs, but did not significantly impact NADCs.
Authors: Viviane D Lima; Robert S Hogg; P Richard Harrigan; David Moore; Benita Yip; Evan Wood; Julio S G Montaner Journal: AIDS Date: 2007-03-30 Impact factor: 4.177
Authors: Robert J Biggar; Elaine S Jaffe; James J Goedert; Anil Chaturvedi; Ruth Pfeiffer; Eric A Engels Journal: Blood Date: 2006-08-17 Impact factor: 22.113
Authors: Mark Bower; Tom Powles; Mark Nelson; Sundhiya Mandalia; Brian Gazzard; Justin Stebbing Journal: J Natl Cancer Inst Date: 2006-08-02 Impact factor: 13.506
Authors: Bernard M Branson; H Hunter Handsfield; Margaret A Lampe; Robert S Janssen; Allan W Taylor; Sheryl B Lyss; Jill E Clark Journal: MMWR Recomm Rep Date: 2006-09-22
Authors: Scott M Hammer; Michael S Saag; Mauro Schechter; Julio S G Montaner; Robert T Schooley; Donna M Jacobsen; Melanie A Thompson; Charles C J Carpenter; Margaret A Fischl; Brian G Gazzard; Jose M Gatell; Martin S Hirsch; David A Katzenstein; Douglas D Richman; Stefano Vella; Patrick G Yeni; Paul A Volberding Journal: JAMA Date: 2006-08-16 Impact factor: 56.272
Authors: Gregory D Kirk; Christian Merlo; Peter O' Driscoll; Shruti H Mehta; Noya Galai; David Vlahov; Jonathan Samet; Eric A Engels Journal: Clin Infect Dis Date: 2007-05-22 Impact factor: 9.079
Authors: Nancy A Hessol; Sharon Pipkin; Sandra Schwarcz; Rosemary D Cress; Peter Bacchetti; Susan Scheer Journal: Am J Epidemiol Date: 2007-03-06 Impact factor: 4.897
Authors: Elizabeth L Yanik; Sonia Napravnik; Stephen R Cole; Chad J Achenbach; Satish Gopal; Dirk P Dittmer; Andrew F Olshan; Mari M Kitahata; Michael J Mugavero; Michael Saag; Richard D Moore; W Christopher Mathews; Peter Hunt; Joseph J Eron Journal: AIDS Date: 2014-04-24 Impact factor: 4.177
Authors: Pragna Patel; Charles E Rose; Pamela Y Collins; Bernardo Nuche-Berenguer; Vikrant V Sahasrabuddhe; Emmanuel Peprah; Susan Vorkoper; Sonak D Pastakia; Dianne Rausch; Naomi S Levitt Journal: AIDS Date: 2018-07-01 Impact factor: 4.177
Authors: Manfred Hensel; Armin Goetzenich; Thomas Lutz; Albrecht Stoehr; Arend Moll; Jürgen Rockstroh; Nicola Hanhoff; Hans Jäger; Franz Mosthaf Journal: Dtsch Arztebl Int Date: 2011-02-25 Impact factor: 5.594
Authors: Henry Masur; John T Brooks; Constance A Benson; King K Holmes; Alice K Pau; Jonathan E Kaplan Journal: Clin Infect Dis Date: 2014-02-27 Impact factor: 9.079
Authors: Genevieve M Crane; Richard F Ambinder; Courtney M Shirley; Elliot K Fishman; Yvette L Kasamon; Janis M Taube; Michael J Borowitz; Amy S Duffield Journal: Am J Surg Pathol Date: 2014-03 Impact factor: 6.394
Authors: Angel M Mayor; Eduardo J Santiago-Rodriguez; Eddy Rios-Olivares; Guillermo Tortolero-Luna; Robert F Hunter-Mellado Journal: Int J Cancer Res Date: 2016-03-15