Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: Implications for HAART use and NADM development

• Published in: BMC cancer Vol. 17; no. 1; p. 270
• Main Authors: Chiu, Connie G, Smith, Danielle, Salters, Kate A, Zhang, Wendy, Kanters, Steve, Milan, David, Montaner, Julio S G, Coldman, Andy, Hogg, Robert S, Wiseman, Sam M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.04.2017; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - mortality; Acquired Immunodeficiency Syndrome - pathology; Adult; Age Factors; AIDS; Anti-HIV Agents - administration & dosage; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active - methods; British Columbia; British Columbia - epidemiology; Cancer; Cancer screening; Complications and side effects; Epidemiology; Female; Forecasts and trends; HAART; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - mortality; HIV Infections - pathology; Human immunodeficiency virus; Humans; Incidence; Male; Malignancy; Middle Aged; Mortality; Neoplasms - epidemiology; Neoplasms - mortality; Neoplasms - virology; Retrospective Studies; Risk factors; Sex Factors; British Columbia; Canada; Aids; Malignancy; HIV; Epidemiology; Cancer; HAART
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3229-1

The objective of this study is to evaluate the incidence of non-AIDS defining malignancies (NADMs) among people living with HIV/AIDS (PLWHA) in British Columbia, focusing on clinical correlates, highly active antiretroviral therapy (HAART) use, and survival, in order to elucidate mechanisms for NADM development. A retrospective population based analysis was carried out for individuals with HIV/AIDS that began their treatment between 1996 and 2008. There were 145 (2.95%) NADMs and 123 (2.50%) AIDS defining malignancies (ADMs) identified in 4918 PLWHA in the study population. NADMs were represented by a range of cancer types including, most commonly, lung cancer, followed by anal, breast, head/neck, prostate, liver, rectal, and renal cancers. PLWHA had a SIR of 2.05 (CI:1.73, 2.41) for the development of NADMs compared to individuals without an HIV/AIDS diagnosis in the general population. Independent factors significantly associated with a NADM were: male gender, older age, lower CD4 cell counts, previous NADM, absence of HAART (non-HAART versus HAART) and treatment during the early-HAART era (before 2000 versus after 2000). NADMs represent an important source of morbidity for PLWHA. Use of HAART with its associated improvement in immune-restoration, and tailored targeted cancer screening interventions, may be beneficial and improve outcomes in this unique patient population.