Integrase Strand Transfer Inhibitor Use and Cancer Incidence in a Large Cohort Setting.

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 Decem...

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Detalles Bibliográficos
Autores: Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Miró Meda, José M. (José María), 1956-, Dahlerup Rasmussen, Line, Zangerle, Robert, Grabmeier-Pfistershammer, Katharina, Günthard, Huldrych F.., Kusejko, Katharina, Smith, Colette, Mussini, Cristina, Menozzi, Marianna, Wit, Ferdinand, Van Der Valk, Marc, D'Arminio Monforte, Antonella, De Wit, Stéphane, Necsoi, Coca, Pelchen-Matthews, Annegret, Lundgren, Jens, Peters, Lars, Castagna, Antonella, Muccini, Camilla, Vehreschild, Jörg Janne, Pradier, Christian, Bruguera Riera, Andreu, Sönnerborg, Anders, Petoumenos, Kathy, Garges, Harmony, Rogatto, Felipe, Dedes, Nikos, Bansi-Matharu, Loveleen, Mocroft, Amanda, RESPOND Study Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/201400
Acceso en línea:https://hdl.handle.net/2445/201400
Access Level:acceso abierto
Palabra clave:Persones seropositives
Antiretrovirals
Càncer
Inhibidors de la integrasa
HIV-positive persons
Antiretroviral agents
Cancer
Integrase inhibitors
Descripción
Sumario: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.

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