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AIDS. 2008 Oct 18;22(16):2143-53. doi: 10.1097/QAD.0b013e3283112b77.

HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies.

Collaborators (588)

Collins S, Loeliger E, Tressler R, Weller I, Friis-Møller N, Worm SW, Sabin CA, Sjøl A, Lundgren JD, Sawitz A, Rickenbach M, Pezzotti P, Krum E, Gras L, Balestre E, Sundström A, Poll B, Fontas E, Torres F, Petoumenos K, Kjaer J, de Wolf F, Zaheri S, Gras L, Bronsveld W, Hillebrand-Haverkort ME, Prins JM, Bos JC, Schattenkerk JK, Geerlings SE, Godfried MH, Lange JM, van Leth FC, Lowe SH, van der Meer JT, Nellen FJ, Pogány K, van der Poll T, Reiss P, Ruys TA, Sankatsing SR, van Twillert G, van der Valk M, van Vonderen MG, Vrouenraets SM, van Vugt M, Wit FW, van Eeden A, ten Veen JH, van Dam PS, Roos JC, Brinkman K, Frissen PH, Weigel HM, Mulder JW, van Gorp EC, Meenhorst PL, Mairuhu AT, Veenstra J, Danner SA, Van Agtmael MA, Claessen FA, Perenboom RM, Rijkeboer A, van Vonderen M, Richter C, van der Berg J, van Leusen R, Vriesendorp R, Jeurissen FJ, Kauffmann RH, Koger EL, Bravenboer B, ten Napel CH, Kootstra GJ, Sprenger HG, Miesen WM, Doedens R, Scholvinck EH, ten Kate RW, van Houte DP, Polee M, Kroon FP, van den Broek, van Dissel JT, Schippers EF, Schreij G, van de Geest S, Verbon A, Koopmans PP, Keuter M, Post F, van der Ven AJ, van der Ende ME, Gyssens IC, van der Feltz M, den Hollander JG, de Marie S, Nouwen JL, Rijnders BJ, de Vries TE, Juttmann JR, van de Heul C, van Kasteren ME, St Elisabeth SM, Bonten MJ, Borleffs JC, Ellerbroek PM, Hoepelman IM, Jaspers CA, Schouten I, Schurink CA, Blok WL, Tanis AA, Groeneveld PH, Salamon R, Beylot J, Dupon M, Le Bras M, Pellegrin JL, Ragnaud JM, Dabis F, Chêne G, Jacqmin-Gadda H, Thiébaut R, Lawson-Ayayi S, Lavignolle V, Balestre E, Blaizeau MJ, Decoin M, Formaggio AM, Delveaux S, Labarerre S, Uwamaliya B, Vimard E, Merchadou L, Palmer G, Touchard D, Dutoit D, Pereira F, Boulant B, Beylot J, Morlat P, Bernard N, Bonarek M, Bonnet F, Coadou B, Gelie P, Jaubert D, Nouts C, Lacoste D, Dupon M, Dutronc H, Cipriano G, Lafarie S, Chossat I, Lacut JY, Leng B, Pellegrin JL, Mercié P, Viallard JF, Faure I, Rispal P, Cipriano C, Tchamgoué S, Le Bras M, Djossou F, Malvy D, Pivetaud JP, Ragnaud JM, Chambon D, De La Taille C, Galperine T, Lafarie S, Neau D, Ochoa A, Beylot C, Doutre MS, Bezian JH, Moreau JF, Taupin JL, Conri C, Constans J, Couzigou P, Castera L, Fleury H, Lafon ME, Masquelier B, Pellegrin I, Trimoulet P, Moreau F, Mestre C, Series C, Taytard A, Law M, Glenday K, Petoumenos K, Anderson J, Cortissos P, Mijch A, Watson K, Roth N, Nicolson J, Bloch M, Agrawal S, Franic T, Baker D, Vale R, Carr A, Cooper D, Lacey M, Hesse K, Chuah J, Lester D, Fankhauser W, Mallal S, Forsdyke C, Bulgannawar S, Calvo G, Torres F, Mateu S, Domingo P, Sambeat MA, Gatell J, Del Cacho E, Cadafalch J, Fuster M, Codina C, Sirera G, Vaqué A, Clumeck N, De Wit S, Gerard M, Kabeya K, Konopnicki D, Libois A, Payen MC, Poll B, Van Laethem Y, Neaton J, Bartsch G, El-Sadr WM, Krum E, Thompson G, Wentworth D, Luskin-Hawk R, Telzak E, El-Sadr WM, Abrams DI, Cohn D, Markowitz N, Arduino R, Mushatt D, Friedland G, Perez G, Tedaldi E, Fisher E, Gordin F, Crane RL, Sampson J, Baxter J, Kirk O, Olsen CH, Mocroft A, Phillips AN, Lundgren JD, Vetter N, Karpov I, Vassilenko A, Clumeck N, De Wit S, Poll B, Colebunders R, Machala L, Rozsypal H, Sedlacek D, Nielsen J, Benfield T, Gerstoft J, Katzenstein T, Hansen AB, Skinhøj P, Pedersen C, Zilmer K, Katlama C, Viard JP, Girard PM, Saint-Marc T, Vanhems P, Pradier C, Dabis F, Dietrich M, Manegold C, van Lunzen J, Stellbrink HJ, Staszewski S, Bieckel M, Goebel FD, Fätkenheuer C, Rockstroh J, Schmidt RE, Kosmidis J, Gargalianos P, Sambatakou H, Perdios J, Panos G, Filandras A, Banhegyi D, Mulcahy F, Yust I, Burke M, Turner D, Pollack S, Hassoun J, Sthoeger Z, Maayan S, Vella S, Chiesi A, Arici C, Pristerá R, Mazzotta F, Gabbuti A, Esposito R, Bedini A, Chirianni A, Montesarchio E, Vullo V, Santopadre P, Narciso P, Antinori A, Franci P, Zaccarelli M, Lazzarin A, Castagna A, Monforte Ad, Viksna L, Chaplinskas S, Hemmer R, Staub T, Reiss P, Bruun J, Maeland A, Ormaasen V, Knysz B, Gasiorowski J, Horban A, Prokopowicz D, Wiercinska-Drapalo A, Boron-Kaczmarska A, Pynka M, Beniowski M, Mularska E, Trocha H, Antunes F, Mansinho K, Maltez F, Duiculescu D, Babes V, Streinu-Cercel A, Vinogradova E, Rakhmanova A, Jevtovic D, Mokrás M, Staneková D, González-Lahoz J, Sanchez-Conde M, García-Benayas T, Martin-Carbonero L, Soriano V, Clotet B, Jou A, Conejero J, Ruiz L, Tural C, Gatell JM, Miró JM, Zamora L, Blaxhult A, Karlsson A, Pehrson P, Ledergerber B, Weber R, Francioli P, Telenti A, Hirschel B, Soravia-Dunand V, Furrer H, Kravchenko E, Chentsova N, Fisher M, Brettle R, Barton S, Johnson AM, Mercey D, Murphy M, Johnson MA, Weber J, Scullard G, Morfeldt L, Thulin G, Sundström A, Akerlund B, Koppel K, Karlsson A, Flamholc L, Håkangård C, Monforte Ad, Ammassari A, Antinori A, Maggiolo F, Balotta C, Bonfanti P, Capobianchi M, Castagna A, Ceccherini-Silberstein F, Cozzi-Lepri A, Monforte Ad, De Luca A, Gervasoni C, Girardi E, Lo Caputo S, Murri R, Mussini C, Puoti M, Torti C, Moroni M, Carosi G, Cauda R, Chiodo F, Monforte Ad, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Mazzotta F, Panebianco R, Pastore G, Perno CF, Montroni M, Scalise G, Costantini A, Riva A, Tirelli U, Martellotta F, Pastore G, Ladisa N, Suter F, Maggiolo F, Chiodo F, Colangeli V, Fiorini C, Carosi G, Cristini G, Torti C, Minardi C, Bertelli D, Quirino T, Manconi PE, Piano P, Pizzigallo E, D'Alessandro M, Carnevale G, Zoncada A, Ghinelli F, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Lo Caputo S, Grisorio B, Ferrara S, Pagano G, Cassola G, Alessandrini A, Piscopo R, Soscia F, Tacconi L, Orani A, Perini P, Tommasi D, Congedo P, Chiodera F, Castelli P, Moroni M, Lazzarin A, Rizzardini G, Caggese L, Monforte Ad, Galli A, Merli S, Pastecchia C, Moioli MC, Esposito R, Mussini C, Gori A, Cagni S, Abrescia N, Chirianni A, Izzo CM, De Marco M, Viglietti R, Manzillo E, Ferrari C, Pizzaferri P, Filice G, Bruno R, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Cauda R, Andreoni M, Antinori A, Antonucci G, Narciso P, Tozzi V, Vullo V, De Luca A, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Lichtner M, Carletti F, Mura MC, Mannazzu M, Caramello P, Di Perri G, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D, Pradier C, Fontas E, Caissotti C, Dellamonica P, Bentz L, Bernard E, De Salvador-Guillouet F, Durant J, Mondain-Miton V, Perbost I, Prouvost-Keller B, Pugliese P, Rahelinirina V, Roger PM, Vandenbos F, Battegay M, Bernasconi E, Böni J, Bucher H, Bürgisser P, Cattacin S, Cavassini M, Dubs R, Egger M, Elzi L, Erb P, Fischer M, Flepp M, Fontana A, Francioli P, Furrer HJ, Gorgievski M, Günthard H, Hirschel B, Kaiser L, Kind C, Klimkait T, Lauper U, Ledergerber B, Opravil M, Paccaud F, Pantaleo G, Perrin L, Piffaretti JC, Rickenbach M, Schmid CR, Schüpbach J, Speck R, Telenti A, Trkola A, Vernazza P, Weber R, Yerly S.

Author information

  • 1Dipartimento di Medicina, Chirurgia e Odontoiatria, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, via A Di Rudinì 8- 20142 Milano, Italy. antonella.darminio@unimi.it

Abstract

OBJECTIVE:

To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency.

DESIGN:

Observational cohort study.

METHODS:

Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor.

RESULTS:

Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n = 110; nADM: n = 188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/microl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/microl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year.

CONCLUSION:

The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations.

PMID:
18832878
[PubMed - indexed for MEDLINE]
PMCID:
PMC2715844
Free PMC Article

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