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Cancer Epidemiol. 2013 Oct;37(5):719-24. doi: 10.1016/j.canep.2013.05.005. Epub 2013 Jun 14.

Cancer survival in patients with HIV/AIDS in the era of highly active antiretroviral therapy in Taiwan: a population-based cohort study.

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  • 1Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan.

Abstract

OBJECTIVES:

HIV-related immunosuppression has been associated with the development of AIDS-defining malignancies. We examined the overall survival of HIV-infected patients who developed cancer.

DESIGN:

A retrospective cohort study.

METHODS:

Using the Taiwan Longitudinal Health Insurance Database, we compared patients diagnosed with HIV (n=9918) between January 1, 2002, and December 31, 2007 with age-matched controls (n=99,180). Each patient was followed until the end of 2009 (least 2 years after the initial HIV diagnosis) to evaluate the incidence of malignancies.

RESULTS:

The risk of overall malignancies in the HIV-infected cohort was 1.88 times higher than the risk of a first malignancy in the age-matched non-HIV infected cohort (incidence rate ratio [IRR])=2.05, p<0.0001). The diagnosis of a malignancy was negatively correlated with survival in the HIV-infected cohort (p<0.0011), and HIV infection had a synergistic effect on the survival of patients with malignancies compared with the non-HIV infected cohort, all of who had been newly diagnosed with cancer (p<0.0001). However, the difference in the risk of developing nasopharyngeal carcinoma (NPC), a highly prevalent malignancy in Taiwan, between the two cohorts was not significant (IRR=0.22, 95% CI=0.03-1.65).

CONCLUSIONS:

The risk of cancer in HIV-infected patients in Taiwan has increased significantly in the era of highly active antiretroviral therapy. A history of HIV significantly affected the survival of the patients in our study cohort after they developed cancer. Evidence level: 2B.

KEYWORDS:

Cancer survival; HIV/AIDS; Head and neck malignancy; Nasopharyngeal carcinoma

PMID:
23770024
DOI:
10.1016/j.canep.2013.05.005
[PubMed - indexed for MEDLINE]
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