title: Immunosuppression and cancer: A comparison of risks in recipients of organ transplants and in HIV-positive individuals.
abstract: The comparison of cancers occurring excessively among HIV-infected and transplanted individuals may help to elucidate the relationship between immune surveillance, viral infections, and cancer. A longitudinal study was conducted on 2002 HIV-infected Italian subjects, 6072 HIV-infected French individuals, and 2878 Italian recipients of solid organ transplants. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were computed to quantify the risk for cancer, compared with the French and Italian general populations. The SIRs for all cancers were 9.8 (95% CI: 9.0-10.6) for HIV-infected individuals versus 2.2 (95% CI: 1.9-2.5) for transplant recipients. In both groups, most of the excess risk was attributable to virus-related cancers, such as Kaposi's sarcoma (KS; SIR = 451 in HIV-positive individuals, 125 in transplant recipients), non-Hodgkin's lymphoma (NHL; SIR = 62.1 and 11.1, respectively), and liver cancer (SIR = 9.4 and 4.1, respectively). Significantly increased SIRs for anal cancer and Hodgkin's lymphoma were found only among HIV-positive individuals. Among women younger than 40 years of age, a more than 10-fold increase in cervical cancer risk was found in both groups. Among HIV-infected individuals treatment with highly active antiretroviral therapies drastically reduced SIRs for KS and NHL only. These results show that HIV-infected individuals and transplant recipients share a similar pattern of cancer risk, largely due to virus-related cancers.
authors.affiliation: Unità Nefrologia, Dialisi & Terapia Trapianto Renale, Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Busnach
authors.forename: P
authors.initials: P
authors.lastname: Piselli
authors.forename: E
authors.initials: E
authors.lastname: Arbustini
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: P
authors.initials: P
authors.lastname: Burra
authors.forename: M P
authors.initials: MP
authors.lastname: Carrieri
authors.forename: F
authors.initials: F
authors.lastname: Citterio
authors.forename: E
authors.initials: E
authors.lastname: De Juli
authors.forename: S
authors.initials: S
authors.lastname: Bellelli
authors.forename: C
authors.initials: C
authors.lastname: Pradier
authors.forename: G
authors.initials: G
authors.lastname: Rezza
authors.forename: D
authors.initials: D
authors.lastname: Serraino
mesh_terms: D015331:Cohort Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000601:surgery*; D006679:HIV Seropositivity; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D007558:Italy; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D016377:Organ Transplantation / Q000009:adverse effects*
chemical_list: D007166:Immunosuppressive Agents