Patterns of HIV viremia and viral suppression before diagnosis of non-AIDS-defining cancers in HIV-infected individuals

Infectious Agents and Cancer

Robert R. Redfield²  Anne F. Rositch³  David J. Riedel¹ 

[1] Institute of Human Virology and Division of Infectious Diseases, University of Maryland School of Medicine, Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Cancer Center, 725 W. Lombard St., N552, Baltimore 21201, MD, USA;Institute of Human Virology and Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, USA;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

关键词: Hodgkin lymphoma;    Anal cancer;    Non-AIDS-defining cancer;    Viremia;    AIDS;    HIV;   

Others  :  1233262
DOI  :  10.1186/s13027-015-0033-x

 received in 2015-06-02, accepted in 2015-09-11,  发布年份 2015

【 摘 要 】

Background

The association between HIV viremia and non-AIDS-defining cancers (NADCs) is not well characterized. Viremia may contribute directly or indirectly to cancer development and may have a differential impact on various cancer types. Our objective was to characterize patterns of HIV viremia in a retrospective, urban, clinical cohort (N = 320) of patients diagnosed with NADCs.

Findings

The most common NADC’s were lung (n = 60), prostate (n = 47), oropharyngeal (n = 32), liver (n = 29), and anal cancer (n = 20) and Hodgkin lymphoma (n = 18). In the year before cancer diagnosis, 66 % of all patients were virally suppressed. Patients with oropharyngeal (70 %) and prostate cancer (78 %) had a higher proportion of visits with suppressed viral loads. Patients diagnosed with anal cancer and Hodgkin lymphoma were infrequently virally suppressed and more frequently had viral loads ≥5 log ₁₀copies/ml in the ten years prior to cancer diagnosis.

Conclusions

In this cohort of HIV-infected patients diagnosed with NADCs, there were important differences in the patterns and levels of viremia between the different NADCs in the ten years prior to cancer diagnosis. Patients with anal cancer and Hodgkin lymphoma had the highest proportion of high level viremia in the ten years before cancer and the lowest frequency of viral load suppression at cancer diagnosis.

【 授权许可】

   
2015 Riedel et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Guiguet M, Boue F, Cadranel J, Lang JM, Rosenthal E, Costagliola D: Effect of immunodeficiency, HIV viral load, and antiretroviral therapy on the risk of individual malignancies (FHDH-ANRS CO4): a prospective cohort study. Lancet Oncol 2009, 10(12):1152-9.
• [2]Bruyand M, Thiebaut R, Lawson-Ayayi S, Joly P, Sasco AJ, Mercie P, et al.: Role of uncontrolled HIV RNA level and immunodeficiency in the occurrence of malignancy in HIV-infected patients during the combination antiretroviral therapy era: Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort. Clin Infect Dis 2009, 49(7):1109-16.
• [3]Zoufaly A, Stellbrink HJ, Heiden MA, Kollan C, Hoffmann C, van Lunzen J, et al.: Cumulative HIV viremia during highly active antiretroviral therapy is a strong predictor of AIDS-related lymphoma. J Infect Dis 2009, 200(1):79-87.
• [4]Vallet-Pichard A, Pol S: Hepatitis viruses and human immunodeficiency virus co-infection: pathogenesis and treatment. J Hepatol 2004, 41(1):156-66.
• [5]Clifford GM, Polesel J, Rickenbach M, Dal Maso L, Keiser O, Kofler A, et al.: Cancer risk in the Swiss HIV Cohort Study: associations with immunodeficiency, smoking, and highly active antiretroviral therapy. J Natl Cancer Inst 2005, 97(6):425-32.
• [6]Burgi A, Brodine S, Wegner S, Milazzo M, Wallace MR, Spooner K, et al.: Incidence and risk factors for the occurrence of non-AIDS-defining cancers among human immunodeficiency virus-infected individuals. Cancer 2005, 104(7):1505-11.
• [7]Crum-Cianflone N, Hullsiek KH, Marconi V, Weintrob A, Ganesan A, Barthel RV, et al.: Trends in the incidence of cancers among HIV-infected persons and the impact of antiretroviral therapy: a 20-year cohort study. AIDS 2009, 23(1):41-50.
• [8]Powles T, Robinson D, Stebbing J, Shamash J, Nelson M, Gazzard B, et al.: Highly active antiretroviral therapy and the incidence of non-AIDS-defining cancers in people with HIV infection. J Clin Oncol 2009, 27(6):884-90.
• [9]Kowalkowski MA, Day RS, Du XL, Chan W, Chiao EY: Cumulative HIV viremia and non-AIDS-defining malignancies among a sample of HIV-infected male veterans. J Acquir Immune Defic Syndr 2014, 67(2):204-11.
• [10]Engels EA, Pfeiffer RM, Landgren O, Moore RD: Immunologic and virologic predictors of AIDS-related non-hodgkin lymphoma in the highly active antiretroviral therapy era. J Acquir Immune Defic Syndr 2010, 54(1):78-84.
• [11]Achenbach CJ, Buchanan AL, Cole SR, Hou L, Mugavero MJ, Crane HM, et al.: HIV viremia and incidence of non-Hodgkin lymphoma in patients successfully treated with antiretroviral therapy. Clin Infect Dis 2014, 58(11):1599-606.
• [12]Riedel DJ, Mwangi EI, Fantry LE, Alexander C, Hossain MB, Pauza CD, et al.: High cancer-related mortality in an urban, predominantly African-American, HIV-infected population. AIDS 2013, 27(7):1109-17.
• [13]Silverberg MJ, Chao C, Leyden WA, Xu L, Tang B, Horberg MA, et al.: HIV infection and the risk of cancers with and without a known infectious cause. AIDS 2009, 23(17):2337-45.
• [14]Chaturvedi AK, Engels EA, Anderson WF, Gillison ML: Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 2008, 26(4):612-9.
• [15]Borges AH, Dubrow R, Silverberg MJ. Factors contributing to risk for cancer among HIV-infected individuals, and evidence that earlier combination antiretroviral therapy will alter this risk. Curr Opin HIV AIDS. 2013. doi:10.1097/COH.0000000000000025.
• [16]Engels EA: Non-AIDS-defining malignancies in HIV-infected persons: etiologic puzzles, epidemiologic perils, prevention opportunities. AIDS 2009, 23(8):875-85.
• [17]Tong WW, Hillman RJ, Kelleher AD, Grulich AE, Carr A: Anal intraepithelial neoplasia and squamous cell carcinoma in HIV-infected adults. HIV Med 2014, 15(2):65-76.
• [18]Achenbach CJ, Cole SR, Kitahata MM, Casper C, Willig JH, Mugavero MJ, et al.: Mortality after cancer diagnosis in HIV-infected individuals treated with antiretroviral therapy. AIDS 2011, 25(5):691-700.