| Relationship between current level of immunodeficiency and non-acquired immunodeficiency syndrome-defining malignancies. | |
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MedLine Citation:
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PMID: 20661911 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In the combined antiretroviral therapy (cART) era, non-acquired immunodeficiency syndrome (AIDS)-defining malignancies account for more morbidity and mortality in human immunodeficiency virus-infected patients than AIDS-defining malignancies. However, conflicting data have been reported on the relationship between immunodeficiency and the development of some non-AIDS-defining malignancies. METHODS: A total of 14,453 patients from the prospective, multinational EuroSIDA cohort were included. Malignancies were classified as virus-related, non-virus-related epithelial, and other. The incidence of non-AIDS-defining malignancies was calculated stratified by current CD4 count. Poisson regression was used to investigate factors associated with the development of non-AIDS-defining malignancies. RESULTS: A total of 356 non-AIDS-defining malignancies occurred, with an incidence rate of 4.3 per 1000 person years of follow-up (95% confidence interval [CI], 3.8-4.7); 172 (48.3%) were virus-related, 135 (37.9%) were non-virus-related epithelial, and 49 (13.7%) were classified as other. Anal (69 cases), lung (31 cases), and melanoma (13 cases), respectively, were the most common non-AIDS-defining malignancies within each group. After adjustment, current CD4 was associated with virus-related non-AIDS-defining malignancies (incidence rate ratio [IRR], 0.81 per doubling; 95% CI, 0.75-0.88; P < .0001) and non-virus-related epithelial non-AIDS-defining malignancies (IRR, 0.84; 95% CI, 0.75-0.95; P = .004), but not with other non-AIDS-defining malignancies (IRR, 1.04; 95% CI, 0.83-1.31; P = .73). Current CD4 count was also associated with anal cancer (IRR, 0.86; 95% CI, 0.75-0.99; P = .03), Hodgkin lymphoma (n = 52; IRR, 0.83; 95% CI, 0.73-0.95; P = .005), and lung cancer (IRR, 0.76; 95% CI, 0.64-0.90; P = .0002). CONCLUSIONS: A low current CD4 count was associated with an increased incidence of certain non-AIDS-defining malignancies. Starting cART earlier to reduce the proportion of patients with a low CD4 count may decrease the rate of developing many common non-AIDS-related malignancies. A randomized trial to explore this strategy is urgently needed. |
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Authors:
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Joanne Reekie; Csaba Kosa; Frederik Engsig; Antonella d'Arminio Monforte; Alicja Wiercinska-Drapalo; Pere Domingo; Francisco Antunes; Nathan Clumeck; Ole Kirk; Jens D Lundgren; Amanda Mocroft; |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Cancer Volume: 116 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-08 Completed Date: 2011-01-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 5306-15 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American Cancer Society. |
Affiliation:
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University College London Medical School, London, UK. j.reekie@pcps.ucl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acquired Immunodeficiency Syndrome
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complications* Adult CD4 Lymphocyte Count* Female Humans Incidence Male Neoplasms / complications, epidemiology*, immunology Risk Factors Tumor Virus Infections / epidemiology, immunology |
| Investigator | |
Investigator/Affiliation:
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M Losso / ; C Elias / ; N Vetter / ; R Zangerle / ; I Karpov / ; A Vassilenko / ; V M Mitsura / ; O Suetnov / ; N Clumeck / ; S De Wit / ; M Delforge / ; R Colebunders / ; L Vanderkerckhove / ; V Hadziosmanovic / ; K Kostov / ; J Begovac / ; L Machala / ; H Rozsypal / ; D Sedlacek / ; J Nielsen / ; G Kronborg / ; T Benfield / ; M Larsen / ; J Gerstoft / ; T Katzenstein / ; A -B E Hansen / ; P Skinhoj / ; C Pedersen / ; O D Larsen / ; L Oestergaard / ; K Zilmer / ; J Smidt / ; M Ristola / ; C Katlama / ; J -P Viard / ; P -M Girard / ; J M Livrozet / ; P Vanhems / ; C Pradier / ; F Dabis / ; D Neau / ; J Rockstroh / ; R Schmidt / ; J van Lunzen / ; O Degen / ; H J Stellbrink / ; S Staszewski / ; J Bogner / ; G Fatkenheuer / ; J Kosmidis / ; P Gargalianos / ; G Xylomenos / ; J Perdios / ; G Panos / ; A Filandras / ; E Karabatsaki / ; H Sambatakou / ; D Banhegyi / ; F Mulcahy / ; I Yust / ; D Turner / ; M Burke / ; S Pollack / ; G Hassoun / ; S Mayyan / ; S Vella / ; R Esposito / ; I Mazeau / ; C Mussini / ; C Arici / ; R Pristera / ; F Mazzotta / ; A Gabbuti / ; V Vullo / ; M Lichtner / ; A Chirianni / ; E Montesarchio / ; M Gargiulo / ; G Antonucci / ; F Iacomi / ; P Narciso / ; C Vlassi / ; M Zacarelli / ; A Lazzarin / ; R Finazzi / ; M Galli / ; A Ridolfo / ; A d'Arminio Monforte / ; B Rozental / ; I Zeltina / ; S Chaplinskas / ; R Hemmer / ; T Staub / ; 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 / ; F Antunes / ; E Valadas / ; K Mansinho / ; F Maltez / ; D Duiculescu / ; A Rakhmanova / ; E Vinogradova / ; S Buzunova / ; D Jevtovic / ; M Mokras / ; D Stanekova / ; J Tomazic / ; J Gonzalez-Lahoz / ; V Soriano / ; P Labarga / ; J Medrano / ; S Moreno / ; B Clotet / ; A Jou / ; R Paredes / ; C Tural / ; J Puig / ; I Bravo / ; J M Gatell / ; J M Miro / ; P Domingo / ; M Gutierrez / ; G Mateo / ; M A Sambeat / ; A Karlsson / ; L Flamholc / ; B Ledergerber / ; R Weber / ; P Francioli / ; M Cavassini / ; B Hirschel / ; E Boffi / ; H Furrer / ; M Battegay / ; L Elzi / ; E Kravchenko / ; N Chentsova / ; G Kutsyna / ; S Servitskiy / ; S Antoniak / ; M Krasnov / ; S Barton / ; A M Johnson / ; D Mercey / ; A Phillips / ; M A Johnson / ; A Mocroft / ; M Murphy / ; J Weber / ; G Scullard / ; M Fisher / ; C Leen / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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