AIDS-related cancer and severity of immunosuppression in persons with AIDS

Journal of the National Cancer Institute
Robert J BiggarHIV/AIDS Cancer Match Study

Abstract

The incidence of Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer has been declining among persons with AIDS. We investigated the association between cancer risk and CD4 cell count among such persons. Data from US AIDS registries were linked to local cancer registry data. Cancer incidence per 100,000 person-years was determined for the 4-27 months from the onset of AIDS from January 1, 1990, through December 31, 1995--before highly active antiretroviral therapy (HAART) became available--and from January 1, 1996, through December 31, 2002. The relationships between CD4 count at AIDS onset and cancer incidence were assessed by proportional hazards models. Among 325,516 adults with AIDS, the incidence of Kaposi sarcoma was lower in 1996-2002 (334.6 cases per 100,000 person-years) than in 1990-1995 (1838.9 cases per 100,000 person-years), and the incidence of non-Hodgkin lymphoma followed a similar pattern (i.e., 390.1 cases per 100,000 person-years in 1996-2002 and 1066.2 cases per 100,000 person-years in 1990-1995). In 1996-2002, for each decline in CD4 cell count of 50 cells per microliter of blood, increased risks were found for Kaposi sarcoma (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.33 to 1.50), for...Continue Reading

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