Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: Implications for HAART use and NADM development

BMC Cancer

Research Article

David Milan¹  Wendy Zhang¹  Steve Kanters¹  Julio S.G. Montaner²  Connie G. Chiu³  Sam M. Wiseman³  Danielle Smith⁴  Kate A. Salters⁴  Robert S. Hogg⁴  Andy Coldman⁵ 

[1] British Columbia Centre For Excellence In HIV/AIDS, Providence Health Care, St. Paul’s Hospital, Vancouver, BC, Canada;British Columbia Centre For Excellence In HIV/AIDS, Providence Health Care, St. Paul’s Hospital, Vancouver, BC, Canada;Faculty of Medicine, University of British Columbia, Vancouver, Canada;Department of Surgery, St. Paul’s Hospital, & University of British Columbia, C303 – 1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;Faculty оf Health Sciences, Simon Fraser University, Burnaby, BC, Canada;British Columbia Centre For Excellence In HIV/AIDS, Providence Health Care, St. Paul’s Hospital, Vancouver, BC, Canada;Population and Preventive Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada;

关键词: Cancer;    HIV;    Aids;    Epidemiology;    HAART;    Malignancy;   

DOI  :  10.1186/s12885-017-3229-1

 received in 2016-03-08, accepted in 2017-03-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe objective of this study is to evaluate the incidence of non-AIDS defining malignancies (NADMs) among people living with HIV/AIDS (PLWHA) in British Columbia, focusing on clinical correlates, highly active antiretroviral therapy (HAART) use, and survival, in order to elucidate mechanisms for NADM development.MethodsA retrospective population based analysis was carried out for individuals with HIV/AIDS that began their treatment between 1996 and 2008.ResultsThere were 145 (2.95%) NADMs and 123 (2.50%) AIDS defining malignancies (ADMs) identified in 4918 PLWHA in the study population. NADMs were represented by a range of cancer types including, most commonly, lung cancer, followed by anal, breast, head/neck, prostate, liver, rectal, and renal cancers. PLWHA had a SIR of 2.05 (CI:1.73, 2.41) for the development of NADMs compared to individuals without an HIV/AIDS diagnosis in the general population. Independent factors significantly associated with a NADM were: male gender, older age, lower CD4 cell counts, previous NADM, absence of HAART (non-HAART versus HAART) and treatment during the early-HAART era (before 2000 versus after 2000).ConclusionsNADMs represent an important source of morbidity for PLWHA. Use of HAART with its associated improvement in immune-restoration, and tailored targeted cancer screening interventions, may be beneficial and improve outcomes in this unique patient population.

【 授权许可】

CC BY   
© The Author(s). 2017