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

Abstract

BACKGROUND:

The 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.

METHODS:

A retrospective population based analysis was carried out for individuals with HIV/AIDS that began their treatment between 1996 and 2008.

RESULTS:

There 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).

CONCLUSIONS:

NADMs 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.

• Authors: Connie G Chiu, Danielle Smith, Kate A Salters, Wendy Zhang, Steve Kanters, David Milan, Julio S G Montaner, Andy Coldman, Robert S Hogg, Sam M Wiseman
• Journal: BMC cancer (BMC Cancer) Vol. 17 Issue 1 Pg. 270 (04 14 2017) ISSN: 1471-2407 [Electronic] England
• PMID: 28410587 (Publication Type: Journal Article)

Chemical References

• Anti-HIV Agents

Topics

• Acquired Immunodeficiency Syndrome (drug therapy, epidemiology, mortality, pathology)
• Adult
• Age Factors
• Anti-HIV Agents (administration & dosage)
• Antiretroviral Therapy, Highly Active (methods)
• British Columbia (epidemiology)
• Female
• HIV Infections (drug therapy, epidemiology, mortality, pathology)
• Humans
• Incidence
• Male
• Middle Aged
• Neoplasms (epidemiology, mortality, virology)
• Retrospective Studies
• Sex Factors