Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Miro, Jose M., Rasmussen, Line Dahlerup ORCID: 0000-0003-0853-0893, Zangerle, Robert, Grabmeier-Pfistershammer, Katharina, Gunthard, Huldrych F., Kusejko, Katharina ORCID: 0000-0002-4638-1940, Smith, Colette, Mussini, Cristina, Menozzi, Marianna, Wit, Ferdinand, Van der Valk, Marc, Monforte, Antonella d'Arminio, De Wit, Stephane, Necsoi, Coca, Pelchen-Matthews, Annegret, Lundgren, Jens ORCID: 0000-0001-8901-7850, Peters, Lars, Castagna, Antonella, Muccini, Camilla, Vehreschild, Joerg Janne, Pradier, Christian, Riera, Andreu Bruguera, Sonnerborg, Anders, Petoumenos, Kathy, Garges, Harmony, Rogatto, Felipe, Dedes, Nikos, Bansi-Matharu, Loveleen and Mocroft, Amanda (2022). Integrase Strand Transfer Inhibitor Use and Cancer Incidence in a Large Cohort Setting. Open Forum Infect. Dis., 9 (3). CARY: OXFORD UNIV PRESS INC. ISSN 2328-8957

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Abstract

In this analysis including 29 340 individuals from RESPOND and 1078 cancer events, the incidence of cancer decreased as cumulative INSTI exposure increased in ART-naive individuals, however there was no association between cancer risk and INSTI exposure in ART-experienced individuals. Background Limited data exist examining the association between incident cancer and cumulative integrase inhibitor (INSTI) exposure. Methods Participants were followed from baseline (latest of local cohort enrollment or January 1, 2012) until the earliest of first cancer, final follow-up, or December 31, 2019. Negative binomial regression was used to assess associations between cancer incidence and time-updated cumulative INSTI exposure, lagged by 6 months. Results Of 29 340 individuals, 74% were male, 24% were antiretroviral treatment (ART)-naive, and median baseline age was 44 years (interquartile range [IQR], 36-51). Overall, 13 950 (48%) individuals started an INSTI during follow-up. During 160 657 person-years of follow-up ([PYFU] median 6.2; IQR, 3.9-7.5), there were 1078 cancers (incidence rate [IR] 6.7/1000 PYFU; 95% confidence interval [CI], 6.3-7.1). The commonest cancers were non-Hodgkin lymphoma (n = 113), lung cancer (112), Kaposi's sarcoma (106), and anal cancer (103). After adjusting for potential confounders, there was no association between cancer risk and INSTI exposure (<= 6 months vs no exposure IR ratio: 1.15 [95% CI, 0.89-1.49], >6-12 months; 0.97 [95% CI, 0.71-1.32], >12-24 months; 0.84 [95% CI, 0.64-1.11], >24-36 months; 1.10 [95% CI, 0.82-1.47], >36 months; 0.90 [95% CI, 0.65-1.26] [P = .60]). In ART-naive participants, cancer incidence decreased with increasing INSTI exposure, mainly driven by a decreasing incidence of acquired immune deficiency syndrome cancers; however, there was no association between INSTI exposure and cancer for those ART-experienced (interaction P < .0001). Conclusions Cancer incidence in each INSTI exposure group was similar, despite relatively wide CIs, providing reassuring early findings that increasing INSTI exposure is unlikely to be associated with an increased cancer risk, although longer follow-up is needed to confirm this finding.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Greenberg, LaurenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ryom, LeneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neesgaard, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miro, Jose M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rasmussen, Line DahlerupUNSPECIFIEDorcid.org/0000-0003-0853-0893UNSPECIFIED
Zangerle, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabmeier-Pfistershammer, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gunthard, Huldrych F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kusejko, KatharinaUNSPECIFIEDorcid.org/0000-0002-4638-1940UNSPECIFIED
Smith, ColetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Menozzi, MariannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wit, FerdinandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van der Valk, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monforte, Antonella d'ArminioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Wit, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Necsoi, CocaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pelchen-Matthews, AnnegretUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lundgren, JensUNSPECIFIEDorcid.org/0000-0001-8901-7850UNSPECIFIED
Peters, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castagna, AntonellaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muccini, CamillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Joerg JanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pradier, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riera, Andreu BrugueraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sonnerborg, AndersUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petoumenos, KathyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garges, HarmonyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rogatto, FelipeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dedes, NikosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bansi-Matharu, LoveleenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mocroft, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-697755
DOI: 10.1093/ofid/ofac029
Journal or Publication Title: Open Forum Infect. Dis.
Volume: 9
Number: 3
Date: 2022
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 2328-8957
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COMBINATION ANTIRETROVIRAL THERAPY; AIDS-DEFINING MALIGNANCIES; CHANGING PATTERNS; INITIAL TREATMENT; HIV-1 INFECTION; LIFE EXPECTANCY; DOUBLE-BLIND; RISK; RALTEGRAVIR; TRENDSMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69775

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