High-density lipoprotein-cholesterol levels and risk of cancer in HIV-infected subjects: Data from the ICONA Foundation Cohort.
Investigation of the relationship between high-density lipoprotein-cholesterol (HDL-c) and the risk of developing cancer in a prospective cohort of human immunodeficiency virus (HIV)-infected patients.The Italian Cohort of Antiretroviral-naïve Patients Foundation Cohort is an Italian multicenter observational study recruiting HIV-positive patients while still antiretroviral treatment-naïve, regardless of the reason since 1997.Patients with at least 1 HDL-c value per year since enrollment and one such value before antiretroviral treatment initiation were included. HDL-c values were categorized as either low (<39 mg/dL in males or <49 mg/dL in females) or normal. Cancer diagnoses were classified as AIDS-defining malignancies (ADMs) or non-AIDS-defining malignancies (NADMs). Kaplan-Meier curves and Cox proportional-hazards regression models were used.Among 4897 patients (13,440 person-years of follow-up [PYFU]), 104 diagnoses of cancer were observed (56 ADMs, 48 NADMs) for an overall incidence rate of 7.7 (95% confidence interval [CI] 6.3-9.2) per 1000 PYFU.Low HDL-c values at enrollment were associated with higher risk both of cancer (crude hazard ratio [HR] 1.72, 95% CI 1.16-2.56, P = 0.007) and of NADM (crude HR 2.50, 95% CI 1.35-4.76, P = 0.003). Multivariate analysis showed that the risk of cancer diagnosis was higher in patients with low HDL-c values (adjusted HR [AHR] 1.87, 95% CI 1.18-2.95, P = 0.007) in older patients, those patients more recently enrolled, and in those with low current cluster of differentiation 4+ levels, and/or high current HIV-ribonucleic acid.The multivariate model confirmed an association between HDL-c (AHR 2.61, 95% CI 1.40-4.89, P = 0.003) and risk of NADM.Low HDL-c is an independent predictor of cancer in HIV-1-infected subjects.
Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza Infectious Diseases Department, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari Infectious and Tropical Diseases Unit I, Department of Infectious Diseases, Amedeo di Savoia Hospital, Torino Clinical Department, National Institute of Infectious Diseases 'L.Spallanzani', Rome Division of Infectious Diseases, Padova Hospital, Padova Division of Infectious Diseases, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo Department of Publich Health, Infectious Diseases, Catholic University, Rome Department of Health Sciences, Clinic of Infectious Diseases, 'San Paolo' Hospital, University of Milan, Milan, Italy.
Nicola
N
Squillace
Laura
L
Galli
Alessandra
A
Bandera
Antonella
A
Castagna
Giordano
G
Madeddu
Pietro
P
Caramello
Andrea
A
Antinori
Annamaria
A
Cattelan
Franco
F
Maggiolo
Antonella
A
Cingolani
Andrea
A
Gori
Antonella d'Arminio
AD
Monforte
D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000821:virology; D018570:Risk Assessment
D008076:Cholesterol, HDL