Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

PurposeOur aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors.MethodsWe included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004-2021). We estimat...

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Detalles Bibliográficos
Autores: Suárez García, I., Gutiérrez, Félix, Pérez Molina, José A., Moreno, Santiago, Aldamiz, Teresa, Valencia Ortega, Eulalia, Curran, Adrián, Gutiérrez González, Sara, Asensi, Victor, Prous, Concha Amador, Jarrin, Inma, Rava, Marta
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Consejo General de la Arquitectura Técnica de España (CGATE)
Repositorio:RIARTE
OAI Identifier:oai:www.riarte.es:20.500.12251/3376
Acceso en línea:http://hdl.handle.net/20.500.12251/3376
https://doi.org/10.1007/s00432-023-05500-9
Access Level:acceso abierto
Palabra clave:Mortalidad
Cáncer
Factor de riesgo
Tabaco
Análisis multivariante
5205.01 Causas de la Mortalidad
3207.03 Carcinogénesis
3214 Toxicología
6305.03 Análisis Estadístico
1209.01 Estadística Analítica
Descripción
Sumario:PurposeOur aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors.MethodsWe included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004-2021). We estimated mortality rates and standardised mortality ratios (SMRs). We used cause-specific Cox models to identify risk factors.ResultsAmong 17,978 PLWH, NADC caused 21% of all deaths observed during the follow-up. Mortality rate due to NADC was 1.58 (95%CI 1.36, 1.83) x 1000 person-years and lung and liver were the most frequent cancer-related causes of death. PLWH had 79% excess NADC mortality risk compared to the general population with the highest SMR found for Hodgkin lymphoma, anal and liver cancers. The SMRs decreased with age and were the highest in age groups under 50 years. The most important prognostic factor was low CD4 count, followed by smoking, viral hepatitis and HIV transmission through heterosexual contact or injection drug use.ConclusionNon-AIDS cancers are an important cause of death among PLWH. The excess mortality related to certain malignancies and the association with immunodeficiency, smoking, and coinfections highlights the need for early detection and treatment of cancer in this population.

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