Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/12326
Cause-specific mortality after diagnosis of cancer among HIV-positive patients: A collaborative analysis of cohort studies.
Trickey, Adam | May, Margaret T | Gill, M John | Grabar, Sophie | Vehreschild, Janne | Wit, Ferdinand W N M | Bonnet, Fabrice | Cavassini, Matthias | Abgrall, Sophie | Berenguer, Juan | Wyen, Christoph | Reiss, Peter | Grabmeier-Pfistershammer, Katharina | Guest, Jodie L | Shepherd, Leah | Teira, Ramon | d'Arminio Monforte, Antonella | Amo, Julia del ISCIII | Justice, Amy C | Costagliola, Dominique | Sterne, Jonathan A C
Int J Cancer . 2020 Jun 1;146(11):3134-3146.
People living with HIV (PLHIV) are more likely than the general population to develop AIDS-defining malignancies (ADMs) and several non-ADMs (NADMs). Information is lacking on survival outcomes and cause-specific mortality after cancer diagnosis among PLHIV. We investigated causes of death within 5 years of cancer diagnosis in PLHIV enrolled in European and North American HIV cohorts starting antiretroviral therapy (ART) 1996-2015, aged ≥16 years, and subsequently diagnosed with cancer. Cancers were grouped: ADMs, viral NADMs and nonviral NADMs. We calculated cause-specific mortality rates (MR) after diagnosis of specific cancers and compared 5-year survival with the UK and France general populations. Among 83,856 PLHIV there were 4,436 cancer diagnoses. Of 603 deaths after ADM diagnosis, 292 (48%) were due to an ADM. There were 467/847 (55%) and 74/189 (39%) deaths that were due to an NADM after nonviral and viral NADM diagnoses, respectively. MR were higher for diagnoses between 1996 and 2005 versus 2006-2015: ADMs 102 (95% CI 92-113) per 1,000 years versus 88 (78-100), viral NADMs 134 (106-169) versus 111 (93-133) and nonviral NADMs 264 (232-300) versus 226 (206-248). Estimated 5-year survival for PLHIV diagnosed with liver (29% [19-39%]), lung (18% [13-23%]) and cervical (75% [63-84%]) cancer was similar to general populations. Survival after Hodgkin's lymphoma diagnosis was lower in PLHIV (75% [67-81%]). Among ART-treated PLHIV diagnosed with cancer, MR and causes of death varied by cancer type, with mortality highest for liver and lung cancers. Deaths within 5 years of NADM diagnoses were more likely to be from cancer than AIDS.
Acquired Immunodeficiency Syndrome | Adult | Female | France | Hodgkin Disease | Humans | Liver Neoplasms | Lung Neoplasms | Lymphoma, AIDS-Related | Middle Aged | Prognosis | Survival Rate | United Kingdom | Uterine Cervical Neoplasms
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