Use of antidepressants and risk of cancer in individuals infected with HIV.
OBJECTIVE
Preclinical and cohort studies suggest that certain antidepressants are associated with a predisposition to cancer whereas others decrease the risk. We aimed to assess whether different classes of antidepressants were associated with changes in cancer incidence in a population of HIV-1 infected individuals, based on duration of exposure.


METHODS
Antidepressant exposure was measured from date of first prescription of the antidepressant until the date of last follow-up or cancer diagnosis. Univariate and multivariate analyses were performed to establish the risk of AIDS-related cancers and non-AIDS-related cancers according to whether patients were receiving selective serotonin reuptake inhibitors, tricyclic antidepressants, or other medicines for depression. We analyzed data for time exposed to antidepressants, before and during the era of highly active antiretroviral therapy (HAART).


RESULTS
From a cohort of 10,997 patients representing 52,656 years of follow-up attending a large HIV center during the pre-HAART and HAART eras, a total of 2,004 (18%) were prescribed antidepressants representing 15,850 years exposed. A total of 1,607 (15%) individuals were diagnosed with cancer. There were no significant associations between any class of antidepressant and any type of cancer (P = .19), in either the pre-HAART or HAART era (P = .23), and use of serotonin reuptake inhibitors did not alter the risk of Burkitt lymphoma.


CONCLUSIONS
Antidepressants, irrespective of their class, do not affect cancer risk in HIV-infected individuals.
Stebbing
Justin
J
Imperial College, Imperial Healthcare NHS Trust, Charing Cross Hospital, Department of Medical Oncology, London, UK. j.stebbing@ic.ac.uk
Powles
Tom
T
Mandalia
Sundhiya
S
Nelson
Mark
M
Gazzard
Brian
B
Bower
Mark
M
D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D016014:Linear Models; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors