Infection-related and -unrelated malignancies, HIV and the aging population

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.

Detaljer

Författare
  • L. Shepherd
  • H. Borges
  • B. Ledergerber
  • P. Domingo
  • A. Castagna
  • J. Rockstroh
  • B. Knysz
  • J. Tomazic
  • I. Karpov
  • O. Kirk
  • Jens D Lundgren
  • A. Mocroft
  • M. Losso
  • M. Kundro
  • N. Vetter
  • R. Zangerle
  • I. Karpov
  • A. Vassilenko
  • V. M. Mitsura
  • O. Suetnov
  • N. Clumeck
  • S. De Wit
  • M. Delforge
  • E. Florence
  • L. Vandekerckhove
  • V. Hadziosmanovic
  • K. Kostov
  • J. Begovac
  • L. Machala
  • D. Jilich
  • D. Sedlacek
  • G. Kronborg
  • T. Benfield
  • M. Larsen
  • J. Gerstoft
  • T. Katzenstein
  • A. B E Hansen
  • P. Skinhøj
  • C. Pedersen
  • L. Ostergaard
  • U. B. Dragsted
  • L. N. Nielsen
  • K. Zilmer
  • J. Smidt
  • M. Ristola
  • C. Katlama
  • J. P. Viard
  • P. M. Girard
  • P. Vanhems
  • C. Pradier
  • F. Dabis
  • D. Neau
  • C. Duvivier
  • J. Rockstroh
  • R. Schmidt
  • J. van Lunzen
  • O. Degen
  • H. J. Stellbrink
  • M. Bickel
  • J. Bogner
  • G. Fätkenheuer
  • J. Kosmidis
  • P. Gargalianos
  • G. Xylomenos
  • J. Perdios
  • H. Sambatakou
  • D. Banhegyi
  • M. Gottfredsson
  • F. Mulcahy
  • I. Yust
  • D. Turner
  • M. Burke
  • S. Pollack
  • G. Hassoun
  • H. Elinav
  • M. Haouzi
  • A. D’Arminio Monforte
  • R. Esposito
  • I. Mazeu
  • C. Mussini
  • C. Arici
  • R. Pristera
  • F. Mazzotta
  • A. Gabbuti
  • V. Vullo
  • M. Lichtner
  • A. Chirianni
  • E. Montesarchio
  • M. Gargiulo
  • G. D‘Offizi
  • C. Taibi
  • A. Antinori
  • A. Lazzarin
  • A. Castagna
  • N. Gianotti
  • M. Galli
  • A. Ridolfo
  • B. Rozentale
  • I. Zeltina
  • S. Chaplinskas
  • R. Hemmer
  • P. Reiss
  • V. Ormaasen
  • A. Maeland
  • J. Bruun
  • B. Knysz
  • J. Gasiorowski
  • A. Horban
  • E. Bakowska
  • A. Grzeszczuk
  • R. Flisiak
  • A. Boron-Kaczmarska
  • M. Pynka
  • M. Parczewski
  • M. Beniowski
  • E. Mularska
  • H. Trocha
  • E. Jablonowska
  • E. Malolepsza
  • K. Wojcik
  • M. Doroana
  • L. Caldeira
  • K. Mansinho
  • F. Maltez
  • D. Duiculescu
  • A. Rakhmanova
  • A. Rakhmanova
  • S. Buzunova
  • I. Khromova
  • E. Kuzovatova
  • D. Jevtovic
  • M. Mokráš
  • D. Staneková
  • J. Tomazic
  • J. González-Lahoz
  • V. Soriano
  • P. Labarga
  • S. Moreno
  • J. M. Rodriguez
  • B. Clotet
  • A. Jou
  • R. Paredes
  • C. Tural
  • J. Puig
  • I. Bravo
  • J. M. Gatell
  • J. M. Miró
  • P. Domingo
  • M. Gutierrez
  • G. Mateo
  • M. A. Sambeat
  • J. Medrano
  • A. BlaxhultBlaxhult
  • L. Flamholc
  • A. Thalme
  • A. Sonnerborg
  • B. Ledergerber
  • R. Weber
  • P. Francioli
  • M. Cavassini
  • B. Hirschel
  • E. Boffi
  • H. Furrer
  • M. Battegay
  • L. Elzi
  • P. Vernazza
  • E. Kravchenko
  • N. Chentsova
  • V. Frolov
  • G. Kutsyna
  • S. Servitskiy
  • A. Kuznetsova
  • G. Kyselyova
  • B. Gazzard
  • A. M. Johnson
  • E. Simons
  • A. Phillips
  • M. A. Johnson
  • A. Mocroft
  • C. Orkin
  • J. Weber
  • G. Scullard
  • M. Fisher
  • C. Leen
  • J. Gatell
  • B. Gazzard
  • A. Horban
  • I. Karpov
  • B. Ledergerber
  • M. Losso
  • A. D’Arminio Monforte
  • C. Pedersen
  • A. Rakhmanova
  • M. Ristola
  • J. Rockstroh
  • S. De Witt
  • J. Lundgren
  • A. Phillips
  • P. Reiss
  • O. Kirk
  • A. Mocroft
  • A. Cozzi-Lepri
  • D. Grint
  • A. Schultze
  • L. Shepherd
  • D. Raben
  • D. Podlekareva
  • J. Kjær
  • L. Peters
  • C. Matthews
  • A. H. Fischer
  • A. Bojesen
  • O. Kirk
  • A. Mocroft
  • J. Grarup
  • P. Reiss
  • A. Cozzi-Lepri
  • R. Thiebaut
  • J. Rockstroh
  • D. Burger
  • R. Paredes
  • J. Kjær
  • L. Peters
Enheter & grupper
Externa organisationer
  • University College London
  • University of Copenhagen
  • University Hospital of Zurich
  • Hospital de Sant Pau
  • San Raffaele Scientific Institute
  • Universitätsklinikum Bonn
  • Wroclaw University
  • University Medical Centre Ljubljana
  • Belarus State Medical University
  • Copenhagen University Hospital
  • Hospital JM Ramos Mejia
  • Pulmologisches Zentrum
  • Medical University of Innsbruck
  • Gomel State Medical University
  • Regional AIDS Centre
  • Saint-Pierre University Hospital
  • Institute of Tropical Medicine Antwerp
  • Ghent University Hospital
  • University Clinical Centre Sarajevo
  • Infectious Diseases Hospital
  • University Hospital of Infectious Diseases
  • Bulovka Hospital
  • University Hospital in Pilsen
  • Hvidovre Hospital
  • Odense University Hospital
  • Aarhus University Hospital Skejby
  • Zealand University Hospital
  • Hillerod Hospital
  • West Tallinn Central Hospital
  • Nakkusosakond Siseklinik
  • Helsinki University Central Hospital
  • Pitié Salpetriere University Paris
  • Hospital Saint-Antoine
  • Université Claude Bernard
  • Hôpital de l’Archet / CHU de Nice
  • Institut Gustave Roussy
  • Hopital Necker Enfants Malades
  • Hannover Medical School
  • University Medical Center Hamburg-Eppendorf
  • IPM Study Center
  • University Hospital Frankfurt
  • University Hospital Munich
  • University of Cologne
  • Athens General Hospital
  • Ippokration General Hospital
  • Szent Lásló Hospital
  • National University Hospital of Iceland
  • Trinity College Dublin
  • Tel Aviv Sourasky Medical Center – Ichilov Hospital
  • Rambam Medical Center
  • Hadassah University Hospital
  • Istituto Di Clinica Malattie Infettive e Tropicale
  • University of Modena
  • Ospedale Riuniti
  • Regional Hospital of Bolzano
  • Azienda Sanitaria Firenze (ASF)
  • Sapienza University of Rome
  • Monaldi Hospital
  • Lazzaro Spallanzani National Institute for Infectious Diseases
  • Luigi Sacco University Hospital
  • Riga Eastern Clinical University Hospital
  • Lithuanian AIDS Centre
  • Centre Hospitalier de Luxembourg
  • Academic Medical Center
  • Oslo university hospital
  • Wrocław Medical University
  • Hospital For Infectious Diseases In Warsaw
  • Medical University of Bialystok
  • Pomeranian Medical University
  • Osrodek Diagnostyki i Terapii AIDS
  • Medical University of Gdansk
  • M. Kopernik District Hospital
  • University of Lisbon
  • Hospital de Egas Moniz
  • Hospital Curry Cabral
  • Victor Babes National Institute
  • Clinical Infectious Disease Hospital named after S.P. Botkin
  • St Petersburg AIDS Centre
  • Novgorod Centre for AIDS
  • Centre for HIV/AIDS and Infectious Diseases
  • Nizhny Novgorod Scientific and Research Institute
  • The Institute for Infectious and Tropical Diseases
  • Derer's University Hospita
  • Hospital Carlos III
  • Hospital Ramón Y Cajal
  • Hospital Universitari Germans Trias i Pujol
  • Hospital Clínic of Barcelona
  • Hospital Universitario Araba
  • Södersjukhuset
  • Skåne University Hospital
  • Karolinska University Hospital
  • Lausanne University Hospital
  • Geneva University Hospital
  • Bern University Hospital
  • University Hospital Basel
  • Kantonsspital St Gallen
  • Kiev Centre for AIDS
  • Luhansk State Medical University
  • Odessa Region AIDS Center
  • Kharkov State Medical University
  • Crimean Republican AIDS Centre
  • Chelsea and Westminster Hospital
  • Royal Free Hospital
  • Queen Mary University
  • Imperial College London
  • Royal Sussex County Hospital
  • Western General Hospital
  • Nantes University Hospital
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Infektionsmedicin

Nyckelord

Originalspråkengelska
Sidor (från-till)590-600
Antal sidor11
TidskriftHIV Medicine
Volym17
Utgivningsnummer8
StatusPublished - 2016 sep 1
PublikationskategoriForskning
Peer review utfördJa