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Meta-Analysis
. 2009 Dec;52(5):611-22.
doi: 10.1097/QAI.0b013e3181b327ca.

A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals

Meredith S Shiels  1 , Stephen R Cole, Gregory D Kirk, Charles Poole
Affiliations
Meta-Analysis

A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals

Meredith S Shiels et al. J Acquir Immune Defic Syndr. 2009 Dec.

Abstract

Objective: To estimate summary standardized incidence ratios (SIRs) of non-AIDS cancers among HIV-infected individuals compared with general population rates overall and stratified by gender, AIDS, and highly active antiretroviral therapy (HAART) era.

Design: A meta-analysis using SIRs from 18 studies of non-AIDS cancer in HIV-infected individuals.

Methods: SIRs for non-AIDS cancers in HIV-infected individuals and 95% confidence limits (CLs) were abstracted from each study. Random effects meta-analyses were used to estimate summary SIRs. Modifications by gender, AIDS, and HAART era were estimated with meta-regression.

Results: Four thousand seven hundred ninety-seven non-AIDS cancers occurred among 625,716 HIV-infected individuals. SIRs for several cancers were elevated. In particular, cancers associated with infections, such as anal (SIR = 28; 95% CL 21 to 35), liver (SIR = 5.6; 95% CL 4.0 to 7.7), and Hodgkin lymphoma (SIR = 11; 95% CL 8.8 to 15) and smoking, such as lung (SIR = 2.6; 95% CL 2.1 to 3.1), kidney (SIR = 1.7; 95% CL 1.3 to 2.2), and laryngeal (SIR = 1.5; 95% CL 1.1 to 2.0). AIDS was associated with greater SIRs for Hodgkin lymphoma, leukemia, lung, brain, and all non-AIDS cancers combined.

Conclusions: HIV-infected individuals may be at an increased risk of developing non-AIDS cancers, particularly those associated with infections and smoking. An association with advanced immune suppression was suggested for certain cancers.

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Figures

Figure 1
Figure 1
Summary standardized incidence ratios (SIRs) and 95% confidence limits for specific types of non-AIDS cancer, by gender.

  1. formula image Women

  2. formula image men

Figure 2
Figure 2
Summary standardized incidence ratios (SIRs) and 95% confidence limits for specific types of non-AIDS cancer, by AIDS status.

  1. formula image No AIDS

  2. formula image AIDS

Figure 3
Figure 3
Summary standardized incidence ratios (SIRs) and 95% confidence limits for specific types of non-AIDS cancer, by Highly Active Antiretroviral Therapy (HAART) era.

  1. formula image No HAART

  2. formula image HAART

See this image and copyright information in PMC

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