title: Cancer rates after year 2000 significantly decrease in children with perinatal HIV infection: a study by the Italian Register for HIV Infection in Children.
abstract: OBJECTIVE
  To evaluate the impact of highly active antiretroviral therapy (HAART) on cancer incidence in HIV-infected children throughout a 20-year period.
  
  
  METHODS
  An observational population study was conducted on 1,190 perinatally HIV-infected children enrolled onto the Italian Register for HIV Infection in Children from 1985 to 2004 and never lost to follow-up (total observation time, 10,037.66 years). Cancer rates were calculated in the pre-HAART (1985 to 1995), early HAART (1996 to 1999), and late HAART (2000 to 2004) periods and compared using Poisson regression adjusted for age. The proportion of HAART-treated children increased from 4.1% in 1996 to 60.4% in 1999 and to 81.5% in 2004. In the same time frame, the proportion of children receiving HAART for at least 2 years increased from 3.1% to 77.0%.
  
  
  RESULTS
  Overall, 35 cancers occurred. Cancer rates were 4.49 (95% CI, 2.37 to 6.64), 4.09 (95% CI, 1.68 to 6.50), and 0.76 (95% CI, 0.00 to 1.80) per 1,000 children per year in 1985 to 1995, 1996 to 1999, and 2000 to 2004, respectively. Notably, there was no significant difference comparing the periods from 1985 to 1995 and 1996 to 1999 (P = .081). By contrast, cancer rates were significantly lower in the period from 2000 to 2004 than in 1996 to 1999 (P < .0001). Results were confirmed by separately analyzing data from children observed from birth (P = .418 for 1985 to 1995 v 1996 to 1999; P = .001 for 1996 to 1999 v 2000 to 2004).
  
  
  CONCLUSIONS
  Dramatically reduced cancer rates were observed only in the late HAART period in parallel to the increasing proportion of children receiving HAART therapy.
authors.affiliation: Department of Pediatrics, University of Florence, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
authors.forename: Clara
authors.initials: C
authors.lastname: Gabiano
authors.forename: Catiuscia
authors.initials: C
authors.lastname: Lisi
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.forename: Osvalda
authors.initials: O
authors.lastname: Rampon
authors.forename: Guido Castelli
authors.initials: GC
authors.lastname: Gattinara
authors.forename: Giulio
authors.initials: G
authors.lastname: De Marco
authors.forename: Patrizia
authors.initials: P
authors.lastname: Osimani
authors.forename: Mariano
authors.initials: M
authors.lastname: Manzionna
authors.forename: Angela
authors.initials: A
authors.lastname: Miniaci
authors.forename: Carlo
authors.initials: C
authors.lastname: Pintor
authors.forename: Raffaella
authors.initials: R
authors.lastname: Rosso
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Alessandra
authors.initials: A
authors.lastname: Viganò
authors.forename: Icilio
authors.initials: I
authors.lastname: Dodi
authors.forename: Anna
authors.initials: A
authors.lastname: Maccabruni
authors.forename: Carlo
authors.initials: C
authors.lastname: Fundarò
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome