A case-control study of non-AIDS-defining cancers in a prospective cohort of HIV-infected patients

Abstract

Introduction: We present a case-control study of non-AIDS-defining cancers (NADCs) in a cohort of HIV-infected patients where we value the incidence, survival and prognostic factors of mortality.

Methods: All NADCs diagnosis conducted from 2007 to 2011 in 7 hospitals were collected prospectively, with a subsequent follow up until December 2013. A control group of 221 HIV patients without a diagnosis of cancer was randomly selected.

Results: Two hundred and twenty-one NADCs were diagnosed in an initial cohort of 7,067 HIV-infected patients. The most common were: hepatocellular carcinoma 20.5%, lung 18.7%, head and neck 11.9% and anal 10.5%. The incidence rate of NADCs development was 7.84/1,000 people-year. In addition to aging and smoking, time on ART (OR 1.11; 95% CI 1.05-1.17) and PI use (OR 1.72; 95% CI 1.0-2.96) increased the risk of developing a NADC. During follow-up 53.42% died, with a median survival time of 199.5 days. In the analysis of the prognostic factors of mortality the low values of CD4 at tumour diagnosis (OR 0.99; 95% CI 0.99-1.0; P=.033), and the previous diagnosis of AIDS (OR 2.06; 95% CI 1.08-3.92) were associated with higher mortality.

Conclusions: Predictors of NADCs in our cohort were age, smoking, CD4 lymphocytes and time on ART. Mortality is high, with NADC risk factors being low CD4 count and previous diagnosis of AIDS.

Keywords: Anal cancer; Antiretroviral therapy; Cáncer anal; Cáncer de cabeza y cuello; Cáncer de piel; Cáncer de pulmón; Enfermedades no definitorias de sida; HIV infection; Head and neck cancer; Hepatocarcinoma; Hepatocellular carcinoma; Hodgkin's lymphoma; Infección por VIH; Linfoma de Hodgkin; Lung cancer; Non AIDS-defining illnesses; Non-AIDS defining cancers; Skin cancer; Tratamiento antirretroviral; Tumores no definitorios de sida.