title: Cancer survival in patients with HIV/AIDS in the era of highly active antiretroviral therapy in Taiwan: a population-based cohort study.
abstract: OBJECTIVE
  HIV-related immunosuppression has been associated with the development of AIDS-defining malignancies. We examined the overall survival of HIV-infected patients who developed cancer.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Using the Taiwan Longitudinal Health Insurance Database, we compared patients diagnosed with HIV (n=9918) between January 1, 2002, and December 31, 2007 with age-matched controls (n=99,180). Each patient was followed until the end of 2009 (least 2 years after the initial HIV diagnosis) to evaluate the incidence of malignancies.
  
  
  RESULTS
  The risk of overall malignancies in the HIV-infected cohort was 1.88 times higher than the risk of a first malignancy in the age-matched non-HIV infected cohort (incidence rate ratio [IRR])=2.05, p<0.0001). The diagnosis of a malignancy was negatively correlated with survival in the HIV-infected cohort (p<0.0011), and HIV infection had a synergistic effect on the survival of patients with malignancies compared with the non-HIV infected cohort, all of who had been newly diagnosed with cancer (p<0.0001). However, the difference in the risk of developing nasopharyngeal carcinoma (NPC), a highly prevalent malignancy in Taiwan, between the two cohorts was not significant (IRR=0.22, 95% CI=0.03-1.65).
  
  
  CONCLUSIONS
  The risk of cancer in HIV-infected patients in Taiwan has increased significantly in the era of highly active antiretroviral therapy. A history of HIV significantly affected the survival of the patients in our study cohort after they developed cancer. Evidence level: 2B.
authors.affiliation: Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chih-Shin
authors.initials: CS
authors.lastname: Lin
authors.forename: Charlene
authors.initials: C
authors.lastname: Lin
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lin
authors.forename: Yung-Song
authors.initials: YS
authors.lastname: Lin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D009369:Neoplasms / Q000453:epidemiology* / Q000821:virology; D013624:Taiwan / Q000453:epidemiology
keywords: Cancer survival; HIV/AIDS; Head and neck malignancy; Nasopharyngeal carcinoma