title: Use of statins and risk of AIDS-defining and non-AIDS-defining malignancies among HIV-1 infected patients on antiretroviral therapy.
abstract: OBJECTIVE
  Previous studies have shown that statins use is associated with a lower mortality risk or occurrence of non-Hodgkin's lymphoma or non-AIDS-defining malignancies (NADMs) in HIV-positive patients. We evaluated the effect of statin therapy on the occurrence of all AIDS-defining malignancy (ADM) and NADM among HIV-positive patients.
  
  
  METHODS
  A chart study on HIV-1 infected patients attending the Infectious Diseases Department of the San Raffaele Scientific Institute, Italy.
  
  
  METHODS
  Incident malignancies diagnosed since antiretroviral treatment (ART) initiation until October 2012 among treated patients not taking statins at ART initiation. Statin therapy had to precede cancer diagnosis, if it occurred. Malignancies that occurred before ART or statin initiation were excluded. Follow-up was calculated since ART initiation until the first cancer diagnosis or loss to follow-up or death or last available visit, whichever occurred first. Results are described as median (interquartile range, IQR).
  
  
  RESULTS
  Five thousand, three hundred and fifty-seven HIV-1 treated patients were included. During 52 663 person-years, 740 (14%) patients had a history of statin use; 375 malignancies occurred: 12 (1.6%) malignancies (0 ADM; 12 NADM, crude incidence rate, 1.3/1000 person-years) among statin users and 363 (7.9%) malignancies (194 ADM; 169 NADM, crude incidence rate, 8.4/1000 person-years) among non-statin users. By multivariate Fine-Gray regression, statin use was associated with a lower risk of cancer [adjusted hazard ratio (95% confidence interval) for ever use: 0.45 (0.17-0.71)].
  
  
  CONCLUSIONS
  Among HIV-1 treated patients, statin use was associated with a lower risk of cancer; the benefit was mainly related to AIDS-defining malignancies. Confirmatory studies are needed to consider the residual confounding likely present in this study.
authors.affiliation: aInfectious Diseases Department, San Raffaele Scientific Institute bUniversità Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Galli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Spagnuolo
authors.forename: Andrea
authors.initials: A
authors.lastname: Poli
authors.forename: Stefania
authors.initials: S
authors.lastname: Salpietro
authors.forename: Nicola
authors.initials: N
authors.lastname: Gianotti
authors.forename: Francesca
authors.initials: F
authors.lastname: Cossarini
authors.forename: Alessia
authors.initials: A
authors.lastname: Carbone
authors.forename: Silvia
authors.initials: S
authors.lastname: Nozza
authors.forename: Simona
authors.initials: S
authors.lastname: Bossolasco
authors.forename: Alba
authors.initials: A
authors.lastname: Bigoloni
authors.forename: Adriano
authors.initials: A
authors.lastname: Lazzarin
authors.forename: Antonella
authors.initials: A
authors.lastname: Castagna
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D018570:Risk Assessment
chemical_list: D044966:Anti-Retroviral Agents; D000924:Anticholesteremic Agents