title: Anal carcinoma in HIV-infected patients in the period 1995-2009: a Danish nationwide cohort study.
abstract: BACKGROUND
  Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis of anal carcinoma.
  
  
  METHODS
  We used Poisson regression to estimate the incidence rate ratios (IRR) of anal carcinoma in (1) a population of HIV patients identified from the Danish HIV Cohort Study (n = 4993) compared with a population control cohort matched on age and gender (n = 59,916) for the period 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma.
  
  
  RESULTS
  Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased risk of anal carcinoma (IRR 7.4, 95% CI 1.4-38.3) compared to fathers of population controls. Mortality after diagnosis of anal carcinoma was increased in male HIV patients compared with the male control cohort (MRR 3.2, 95% CI 1.1-9.2).
  
  
  CONCLUSIONS
  Danish HIV patients, especially MSM, have a considerably increased risk of anal carcinoma. We cannot exclude that fathers of HIV patients have an increased risk of anal carcinoma.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital , Rigshospitalet, DK-2100 Copenhagen Ø , Denmark. Rebeccalegarth@gmail.com
authors.forename: Rebecca
authors.initials: R
authors.lastname: Legarth
authors.forename: Marie
authors.initials: M
authors.lastname: Helleberg
authors.forename: Gitte
authors.initials: G
authors.lastname: Kronborg
authors.forename: Carsten S
authors.initials: CS
authors.lastname: Larsen
authors.forename: Gitte
authors.initials: G
authors.lastname: Pedersen
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.forename: Janne
authors.initials: J
authors.lastname: Jensen
authors.forename: Lars Nørregård
authors.initials: LN
authors.lastname: Nielsen
authors.forename: Jan
authors.initials: J
authors.lastname: Gerstoft
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D016019:Survival Analysis; D016896:Treatment Outcome