title: Cancer, immunodeficiency and antiretroviral treatment: results from the Australian HIV Observational Database (AHOD).
abstract: OBJECTIVE
  The objective of the study was to conduct a within-cohort assessment of risk factors for incident AIDS-defining cancers (ADCs) and non-ADCs (NADCs) within the Australian HIV Observational Database (AHOD).
  
  
  METHODS
  A total of 2181 AHOD registrants were linked to the National AIDS Registry/National HIV Database (NAR/NHD) and the Australian Cancer Registry to identify those with a notified cancer diagnosis. Included in the current analyses were cancers diagnosed after HIV infection. Risk factors for cancers were also assessed using logistic regression methods.
  
  
  RESULTS
  One hundred and thirty-nine cancer cases were diagnosed after HIV infection among 129 patients. More than half the diagnoses (n = 68; 60%) were ADCs, of which 69% were Kaposi's sarcoma and 31% non-Hodgkin's lymphoma. Among the NADCs, the most common cancers were melanoma (n = 10), lung cancer (n = 6), Hodgkin's lymphoma (n = 5) and anal cancer (n = 5). Over a total of 21021 person-years (PY) of follow-up since HIV diagnosis, the overall crude cancer incidence rate for any cancer was 5.09/1000 PY. The overall rate of cancers decreased from 15.9/1000 PY [95% confidence interval (CI) 9.25-25.40/1000 PY] for CD4 counts < 100 cells/μL to 2.4/1000 PY (95% CI 1.62-3.39/1000 PY) for CD4 counts > 350 cells/μL. Lower CD4 cell count and prior AIDS diagnoses were significant predictors for both ADCs and NADCs.
  
  
  CONCLUSIONS
  ADCs remain the predominant cancers in this population, although NADC rates have increased in the more recent time period. Immune deficiency is a risk factor for both ADCs and NADCs.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, Australia. kpetoumenos@kirby.unsw.edu.au
authors.forename: K
authors.initials: K
authors.lastname: Petoumenos
authors.forename: M T
authors.initials: MT
authors.lastname: van Leuwen
authors.forename: C M
authors.initials: CM
authors.lastname: Vajdic
authors.forename: I
authors.initials: I
authors.lastname: Woolley
authors.forename: J
authors.initials: J
authors.lastname: Chuah
authors.forename: D J
authors.initials: DJ
authors.lastname: Templeton
authors.forename: A E
authors.initials: AE
authors.lastname: Grulich
authors.forename: M G
authors.initials: MG
authors.lastname: Law
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000276:immunology; D001315:Australia / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000276:immunology; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000276:immunology; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents