title: Risk of AIDS-defining cancers among HIV-1-infected patients in France between 1992 and 2009: results from the FHDH-ANRS CO4 cohort.
abstract: BACKGROUND
  We examined trends in the incidence of the 3 AIDS-defining cancers (ADCs; Kaposi sarcoma [KS], non-Hodgkin lymphoma [NHL], and cervical cancer) among human immunodeficiency virus (HIV)-infected patients relative to the general population between 1992 and 2009 in France, focusing on age at ADC diagnosis and on patients with controlled viral load and restored immunity on combination antiretroviral therapy (cART).
  
  
  METHODS
  Age- and sex-standardized incidence rates were estimated in patients enrolled in the French hospital database on HIV, and in the general population in France during 4 calendar periods (1992-1996, 1997-2000, 2001-2004, and 2005-2009). Standardized incidence ratios (SIRs) were calculated for all periods and separately for patients on cART, with CD4 counts ≥500 cells/µL for at least 2 years and viral load ≤500 copies/mL.
  
  
  RESULTS
  Although the incidence of ADCs fell significantly across the calendar periods, the risk remained constantly higher in HIV-infected patients than in the general population. In patients with restored immunity, the relative risk remained significantly elevated for KS (SIR = 35.4; 95% confidence interval [CI], 18.3-61.9), and was similar to that of the general population for NHL (SIR = 1.0; 95% CI, .4-1.8). ADCs were diagnosed at a younger age in HIV-infected patients, with a particularly marked difference for NHL (-11.3 years, P < .0001).
  
  
  CONCLUSIONS
  The incidence of all ADCs continued to fall, including cervical cancer, in the cART period, but the risk remained higher than in the general population in 2005-2009. In patients with stably restored immunity, KS remained significantly more frequent than in the general population.
authors.affiliation: INSERM UMR S 943, and.
authors.forename: Mira
authors.initials: M
authors.lastname: Hleyhel
authors.forename: Aurélien
authors.initials: A
authors.lastname: Belot
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Bouvier
authors.forename: Pierre
authors.initials: P
authors.lastname: Tattevin
authors.forename: Jérôme
authors.initials: J
authors.lastname: Pacanowski
authors.forename: Philippe
authors.initials: P
authors.lastname: Genet
authors.forename: Nathalie
authors.initials: N
authors.lastname: De Castro
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Berger
authors.forename: Caroline
authors.initials: C
authors.lastname: Dupont
authors.forename: Armelle
authors.initials: A
authors.lastname: Lavolé
authors.forename: Christian
authors.initials: C
authors.lastname: Pradier
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.forename: Anne
authors.initials: A
authors.lastname: Simon
authors.forename: Valérie
authors.initials: V
authors.lastname: Martinez
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Sophie
authors.initials: S
authors.lastname: Grabar
mesh_terms: D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; aging; cancer; restored immunity; risk