Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis
| Autor: | Amy C. Justice, Angel M. Mayor, Richard D. Moore, Daniel M. Trifiletti, Michael Gill, Fidel A Desir, Mari M. Kitahata, Julie Kobie, Yuezhou Jing, Michael J. Silverberg, Keri N. Althoff, William C. Mathews, Jennifer E. Thorne, Surbhi Grover, Chad J. Achenbach, Samuel Swisher-McClure, Kate Salters, Jessica L Castilho, Charles S. Rabkin, Michael A. Horberg, Rohini Bhatia |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment HIV Infections Article 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Internal medicine Neoplasms medicine Anal cancer Humans Pharmacology (medical) 030212 general & internal medicine Lung cancer Survival analysis Neoplasm Staging Cervical cancer business.industry Mortality rate Cancer Immunosuppression Middle Aged medicine.disease Survival Analysis Infectious Diseases 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999). 79(4) |
| ISSN: | 1944-7884 |
| Popis: | It is not known whether immune dysfunction is associated with increased risk of death after cancer diagnosis in persons with HIV (PWH). AIDS-defining illness (ADI) can signal significant immunosuppression. Our objective was to determine differences in cancer stage and mortality rates in PWH with and without history of ADI.PWH with anal, oropharynx, cervical, lung cancers, or Hodgkin lymphoma diagnoses from January 2000 to December 2009 in the North American AIDS Cohort Collaboration on Research and Design were included.Among 81,865 PWH, 814 had diagnoses included in the study; 341 (39%) had a history of ADI at time of cancer diagnosis. For each cancer type, stage at diagnosis did not differ by ADI (P0.05). Mortality and survival estimates for cervical cancer were limited by n = 5 diagnoses. Adjusted mortality rate ratios showed a 30%-70% increase in mortality among those with ADI for all cancer diagnoses, although only lung cancer was statistically significant. Survival after lung cancer diagnosis was poorer in PWH with ADI vs. without (P = 0.0001); the probability of survival was also poorer in those with ADI at, or before other cancers although not statistically significant.PWH with a history of ADI at lung cancer diagnosis had higher mortality and poorer survival after diagnosis compared to those without. Although not statistically significant, the findings of increased mortality and decreased survival among those with ADI (vs. without) were consistent for all other cancers, suggesting the need for further investigations into the role of HIV-related immune suppression and cancer outcomes. |
| Databáze: | OpenAIRE |
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