Risk of Melanoma in People with HIV/AIDS in the Pre- and Post-HAART Eras: A Systematic Review and Meta-Analysis of Cohort Studies

Autor: Adèle C. Green, Catherine M. Olsen, Lani Knight
Rok vydání: 2014
Předmět:
Male
Melanomas
Oncology
Viral Diseases
Skin Neoplasms
Epidemiology
Immunodeficiency Viruses
immune system diseases
Antiretroviral Therapy
Highly Active
Medicine and Health Sciences
Public and Occupational Health
Melanoma
Skin Tumors
Multidisciplinary
Cancer Risk Factors
Incidence (epidemiology)
virus diseases
Middle Aged
Infectious Diseases
Medical Microbiology
Research Design
Viral Pathogens
Meta-analysis
Physical Sciences
Medicine
Female
Statistics (Mathematics)
Research Article
Cohort study
Adult
Risk
medicine.medical_specialty
Adolescent
Clinical Research Design
Science
MEDLINE
Black People
Dermatology
Research and Analysis Methods
Microbiology
White People
Acquired immunodeficiency syndrome (AIDS)
Internal medicine
Cancer Detection and Diagnosis
medicine
Humans
Statistical Methods
Microbial Pathogens
Proportional Hazards Models
Acquired Immunodeficiency Syndrome
business.industry
Proportional hazards model
Biology and Life Sciences
HIV
Cancers and Neoplasms
medicine.disease
Cutaneous melanoma
Immunology
HIV-1
Preventive Medicine
business
Mathematics
Meta-Analysis
Zdroj: PLoS ONE
PLoS ONE, Vol 9, Iss 4, p e95096 (2014)
ISSN: 1932-6203
Popis: ObjectiveFollowing the introduction of highly active antiretroviral therapy (HAART) the risk of AIDS-defining cancers decreased but incidence of many non-AIDS-defining cancers has reportedly increased in those with HIV/AIDS. Whether melanoma risk has also changed in HIV/AIDS patients post-HAART is unknown and therefore we evaluated this in comparison with the risk before HAART.DesignSystematic review and meta-analysis.MethodsWe searched Medline, Embase and ISI science citation index databases to April 2013. All cohort studies of patients diagnosed with HIV/AIDS that permitted quantitative assessment of the association with melanoma were eligible. Detailed quality assessment of eligible studies was conducted, focussing particularly on adjustment for ethnicity, a priori considered essential for an unbiased assessment of melanoma risk. Data were pooled using a random effects model.ResultsFrom 288 articles, we identified 21 that met the inclusion criteria, 13 presenting data for the post-HAART era and 8 for the pre-HAART era. Post-HAART the pooled relative risk (pRR) for the association between HIV/AIDS and melanoma was 1.26 (95% CI, 0.97-1.64) and 1.50 (95% CI 1.12-2.01) among studies that accounted for ethnicity, with evidence of significant heterogeneity (P = 0.004, I2 = 55.5). Pre-HAART pRRs were 1.26 (95% CI 1.11-1.43; P het = 0.82) and 1.28 (95% CI 1.10-1.49) among studies adjusted for ethnicity.ConclusionsPeople with HIV/AIDS remain at a significantly increased risk of developing melanoma in the post-HAART era. White skinned people with HIV/AIDS should be screened regularly and counselled against excessive sun exposure.
Databáze: OpenAIRE
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