Immunodeficiency as a Risk Factor for Non-AIDS-Defining Malignancies in HIV-1-Infected Patients Receiving Combination Antiretroviral Therapy
| Autor: | Anouk M. Kesselring, Gitte van Twillert, Luuk Gras, Colette Smit, Ferdinand W. N. M. Wit, Peter Reiss, Annelies Verbon, Frank de Wolf |
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| Přispěvatelé: | Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Global Health, Internal Medicine |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Microbiology (medical) Oncology medicine.medical_specialty Anti-HIV Agents Statistics as Topic Cumulative Exposure Acquired immunodeficiency syndrome (AIDS) SDG 3 - Good Health and Well-being Risk Factors Antiretroviral Therapy Highly Active Neoplasms Internal medicine Humans Medicine Viremia Risk factor Immunodeficiency Netherlands Acquired Immunodeficiency Syndrome business.industry Proportional hazards model Hazard ratio Middle Aged Viral Load medicine.disease CD4 Lymphocyte Count Infectious Diseases Cohort Immunology HIV-1 Female business Viral load |
| Zdroj: | Clinical infectious diseases, 52(12), 1458-1465. Oxford University Press Clinical Infectious Diseases, 52(12), 1458-1465. Oxford University Press |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background. The aim of this study was to investigate the association between immunodeficiency, viremia, and non-AIDS-defining malignancies (NADM). Methods. Patients starting combination antiretroviral therapy (cART) as of 1 January 1996 were selected from the AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. In Cox models, risk factors for NADM were investigated. These included age, sex, transmission route, smoking, alcohol abuse, prior AIDS diagnosis, duration of exposure to cART, and estimated duration of human immunodeficiency virus infection. CD4+ cell count and viral load (VL) were considered as time-updated variables and as measures of cumulative exposure to CD4+ cell counts of 50, >400, and >1000 copies/mL, respectively. Results. In a cohort of 11,459 patients, 236 NADMs were diagnosed; 102 were caused by infection, and 134 were attributable to other causes. Median CD41 cell count at NADM diagnosis was 340 cells/mm(3) (range, 210-540 cells/mm(3)). Median time to first NADM after starting cART was 5.0 years (range, 2.2-8.2 years). In multivariate models, cumulative exposure to CD41 cell counts,200 cells/mm(3) remained significant (hazard ratio [HR], 1.12; range, 1.03-1.22) for each additional year of exposure. In stratified analyses, cumulative exposure to CD41 cell counts,200 cells/mm(3) was associated with malignancies possibly caused by infection (HR, 1.16; range, 1.03-1.31]) but was not associated with other types of cancers. No significant effect of viremia was seen in either type of cancer. Conclusions. Cumulative exposure to CD41 cell counts |
| Databáze: | OpenAIRE |
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