CMV plasma DNAemia and risk of cancer among HIV-infected patients: a case-control study nested in the ANRS CO3 Aquitaine Cohort, France, 2002-2007.
BACKGROUND
CMV reactivation, which enhances immune senescence, could be associated with a higher risk of cancer.


OBJECTIVE
We compared the prevalence of positive CMV DNAemia in HIV-infected patients with and without cancer.


METHODS
This case-control study, nested in the ANRS-CO3 Aquitaine Cohort, included patients with a first diagnosis of cancer (2002-2007) as cases. Two controls were matched per case. Cancer risk was estimated using conditional logistic regression models, an Odds Ratio (OR) of 2 could be detected with 80% power. The variables considered were: ≥ 1 positive CMV DNAemia, CD4+ and CD8+ counts, HIV plasma load. Plasma CMV DNA was retrospectively quantified within the 3-year period preceding the endpoint.


RESULTS
The 143 cases (93 non-AIDS-related and 50 AIDS-related cancers) and 284 controls had a median age of 47 years (IQR: 41-56). At the time of diagnosis or censorship, for cases and controls, median values were respectively, for CD4+ count: 327 cells/mm(3) (IQR: 164-514) and 416 (IQR: 275-582), and for HIV plasma load: 2.6 log(10)copies/mL (IQR: 1.7-4.7) and 1.7 log(10)copies/mL (IQR: 1.7-3.3). We performed 2056 CMV PCR; 14 cases (9.8% [95% CI: 4.9-14.7]) and 19 controls (6.7% [CI: 3.8-9.6]) presented ≥ 1 positive PCR. CMV DNAemia was not associated with the risk of cancer (unadjusted and adjusted p-values=0.19 and 0.54, respectively). HIV load >500 copies/mL was independently associated with a higher risk of cancer (OR=2.02; p=0.002; 95% CI: 1.29-3.17).


CONCLUSIONS
This large case-control study did not show any differential exposure to positive CMV plasma DNAemia between cancer cases and controls.
INSERM U 897 Epidemiology and Biostatistics, Bordeaux, France.
Mathias
M
Bruyand
Marie-Anne
MA
Vandenhende
Guillaume
G
Marcel
Estibaliz
E
Lazaro
Marie-Edith
ME
Lafon
Michel
M
Dupon
François
F
Dabis
Stéphane
S
Geffard
Hervé
H
Fleury
Muriel
M
Faure-Della Corte
Fabrice
F
Bonnet
Rodolphe
R
Thiebaut
Isabelle
I
Garrigue
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D016022:Case-Control Studies; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D012306:Risk; D012307:Risk Factors; D014766:Viremia; D014775:Virus Activation
D004279:DNA, Viral