HIV infection and the risk of cancers with and without a known infectious cause
Open accessAbstract
OBJECTIVE: To evaluate the risk of cancers with and without a known infectious cause in HIV-infected persons. DESIGN: Retrospective cohort study. METHODS: Adult HIV-infected and matched HIV-uninfected members of Kaiser Permanente followed between 1996 and 2007 for incident AIDS-defining cancers (ADCs), infection-related non-AIDS-defining cancers (NADCs; anal squamous cell, vagina/vulva, Hodgkin's lymphoma, penis, liver, human papillomavirus-related oral cavity/pharynx, stomach) and infection-unrelated NADC (all other NADCs). RESULTS: We identified 20 277 HIV-infected and 202 313 HIV-uninfected persons. HIV-infected persons experienced 552 ADC, 221 infection-related NADC, and 388 infection-unrelated NADC. HIV-uninfected persons experienced 179 ADC, 284 infection-related NADC, and 3418 infection-unrelated NADC. The rate ratio comparing HIV-infected and HIV-uninfected persons for ADC was 37.7 [95% confidence interval (CI): 31.7-44.8], with decreases in the rate ratio over time (P < 0.001). The rate ratio for infection-related NADC was 9.2 (95% CI: 7.7-11.1), also with decreases in the rate ratio over time (P < 0.001). These results were largely influenced by anal squamous cell cancer and Hodgkin's lymphoma. The rate ratio for infection-unrelated NADC was 1.3 (95% CI: 1.2-1.4), with no change in the rate ratio over time (P = 0.44). Among infection-unrelated NADCs, other anal, skin, other head and neck, and lung cancer rates were higher and prostate cancer rates lower in HIV-infected persons. Among all infection-unrelated NADCs, the rate ratio decreased over time only for lung cancer (P = 0.007). CONCLUSION: In comparison with those without HIV infection, HIV-infected persons are at particular risk for cancers with a known infectious cause, although the higher risk has decreased in the antiretroviral therapy era. Cancers without a known infectious cause are modestly increased in HIV-infected persons compared with HIV-uninfected persons.
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HIV-associated, Non-AIDS (HANA) conditions include cardiovascular disease, a number of infectious and noninfectious cancers, osteopenia/osteoporosis, liver disease, renal disease, and neurocognitive decline.
“These include cardiovascular disease (6), a number of infectious and noninfectious cancers (7,8), osteopenia/osteoporosis (9), liver disease (10), renal disease (11,12) and neurocognitive decline.”
HANA conditions include cardiovascular disease, infectious and noninfectious cancers, osteopenia/osteoporosis, liver cirrhosis, and renal disease.
“These include cardiovascular disease, a number of infectious and noninfectious cancers (7,8), osteopenia/osteoporosis(9), liver cirrhosis (10), and renal disease (11, 12).”
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- Authors
- Silverberg, M. J., Chao, C., Leyden, W. A., Xu, L., Tang, B., Horberg, M. A., Klein, D., Quesenberry, C. P., Towner, W. J., & Abrams, D. I.
- Affiliations
- Kaiser Permanente (US)
- Kaiser Permanente Hayward Medical Center (US)
- San Francisco General Hospital (US)
- Corresponding author
- Silverberg, Michael J
- ORCID
- Venue
- AIDS
- Published
- 2009-11-13
- Volume
- 23
- Issue
- 17
- Pages
- 2337-2345
- ISSN
- 0269-9370 (ISSN-L)
- PMC
- PMC2863991
- OpenAlex
- W2075517895
- Cited by
- 299
- References
- 0
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 17 · 2022: 8 · 2021: 16 · 2020: 15 · 2019: 17 · 2018: 11 · 2017: 26 · 2016: 23 · 2015: 35 · 2014: 32 · 2013: 18 · 2012: 29
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Kaiser Permanente
- National Institute on Alcohol Abuse and Alcoholism (R01AA016893)
- National Institute of Allergy and Infectious Diseases (U01AI069918, K01AI071725)
- Topics
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV infection, AIDS-defining cancers, non-AIDS-defining cancers, cancer risk, anal squamous cell carcinoma, Hodgkin's disease, antiretroviral therapy, lung cancer, prostate cancer, human papillomavirus, hepatitis C
- MeSH terms
- Adult, Anus Neoplasms, California, Carcinoma, Squamous Cell, Epidemiologic Methods, Female, Humans, Male, Neoplasms, Registries, HIV Infections, Lymphoma, AIDS-Related, CD4 Lymphocyte Count, Antiretroviral Therapy, Highly Active
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