Universität zu Köln

Worm, Signe W., Bower, Mark ORCID: 0000-0002-4077-6351, Reiss, Peter, Bonnet, Fabrice, Law, Matthew ORCID: 0000-0002-3540-8837, Faetkenheuer, Gerd, Monforte, Antonella d'Arminio, Abrams, Donald I., Grulich, Andrew, Fontas, Eric, Kirk, Ole, Furrer, Hansjakob ORCID: 0000-0002-1375-3146, De Wit, Stephane, Phillips, Andrew, Lundgren, Jens D. and Sabin, Caroline A. (2013). Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival: a cohort study. BMC Infect. Dis., 13. LONDON: BMC. ISSN 1471-2334

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Abstract

Background: Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these. Methods: Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression. Results: Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort. Conclusions: The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Worm, Signe W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bower, Mark UNSPECIFIED orcid.org/0000-0002-4077-6351 UNSPECIFIED Reiss, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonnet, Fabrice UNSPECIFIED UNSPECIFIED UNSPECIFIED Law, Matthew UNSPECIFIED orcid.org/0000-0002-3540-8837 UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Monforte, Antonella d'Arminio UNSPECIFIED UNSPECIFIED UNSPECIFIED Abrams, Donald I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grulich, Andrew UNSPECIFIED UNSPECIFIED UNSPECIFIED Fontas, Eric UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirk, Ole UNSPECIFIED UNSPECIFIED UNSPECIFIED Furrer, Hansjakob UNSPECIFIED orcid.org/0000-0002-1375-3146 UNSPECIFIED De Wit, Stephane UNSPECIFIED UNSPECIFIED UNSPECIFIED Phillips, Andrew UNSPECIFIED UNSPECIFIED UNSPECIFIED Lundgren, Jens D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabin, Caroline A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-474091
DOI:	10.1186/1471-2334-13-471
Journal or Publication Title:	BMC Infect. Dis.
Volume:	13
Date:	2013
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2334
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACTIVE ANTIRETROVIRAL THERAPY; HIV-INFECTED PATIENTS; ANAL CANCER; UNITED-STATES; IMMUNODEFICIENCY; RISK; PEOPLE; DEATH; ERA; POPULATION Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47409