%0 Journal Article
%T Cancer risk in HIV-infected individuals on HAART is largely attributed to oncogenic infections and state of immunocompetence
%A M Vogel
%A O Friedrich
%A G L¨¹chters
%A B Holleczek
%A JC Wasmuth
%A E Anadol
%A C Schwarze-Zander
%A J Nattermann
%A J Oldenburg
%A T Sauerbruch
%A JK Rockstroh
%A U Spengler
%J European Journal of Medical Research
%D 2011
%I BioMed Central
%R 10.1186/2047-783x-16-3-101
%X Long term (1996-2009) cancer incidence of the Bonn single centre HIV cohort was compared to the incidence of the reference population of Saarland using standardized incidence ratios (SIR). Poisson regression analysis was used to identify predictors of cancer risk.1,476 patients entered the cohort, enabling 8,772 person years of observation. 121 tumours in 114 patients, 7 in-situ and 114 invasive cancers, were identified. Malignancies associated with infectious agents such as Kaposi sarcoma (SIRs: male: 5,683; female: 277), non-Hodgkin lymphoma (SIRs male: 35; female: 18), anal cancer (SIRs male: 88; female: 115) as well a cervical carcinoma (SIR female: 4) and Hodgkin's disease (SIR male: 39) and liver cancer (SIR male: 18) were substantially more frequent in HIV-infected patients than in the general population (p < 0.001, each), whereas all other types of cancer were not increased. Poisson regression identified HAART (incidence rate ratio IRR (95% CI): 0.28 (0.19-0.41), p < 0.001), CD4 count (IRR per 100 cells/¦Ìl increase: 0.66 (0.57-0.76), p < 0.001), hepatitis B (IRR: 2.15 (1.10-4.20), p = 0.046) and age (IRR per 10 year increase: 1.23 (1.03 - 1.46), p = 0.023) as independent predictors for the occurrence of any type of cancer.HAART and preserved CD4 cells preferentially reduce the risk of malignancies associated with oncogenic infections.Highly active antiretroviral therapy (HAART) has dramatically reduced the risk for opportunistic infections and improved overall life expectancy in patients with HIV-infection and AIDS [1]. However, the effects of HAART on the known increased rate of malignancies in HIV infected individuals are less clear, and due to the improved life expectancy the burden of malignancy may become more evident [2-4].Certain types of cancer, which are rare in the general population such as Kaposi sarcoma and Non-Hodgkin lymphoma, are apparently linked to immunodeficiency in advanced HIV infection and have been included in the definition of AIDS [
%K Lymphoma
%K Carcinoma
%K HIV
%K CD4-T cells
%K HAART
%U http://www.eurjmedres.com/content/16/3/101