Cause-specific mortality after diagnosis of cancer among HIV-positive patients: A collaborative analysis of cohort studies
International Journal of Cancer Feb 09, 2020
Trickey A, May MT, Gill MJ, et al. - Among people living with HIV (PLHIV) enrolled in European and North American HIV cohorts commencing antiretroviral therapy (ART) 1996–2015, aged ≥ 16 years, and subsequently diagnosed with cancer, researchers inquired the causes of death within 5 years of cancer diagnosis. Cancers were categorized as follows: AIDS-defining malignancies (ADMs), viral non-ADMs (NADMs), and non-viral NADMs. They computed cause-specific mortality rates (MR) after diagnosis of particular cancers, and for comparison of 5-year survival, they used the UK and France general populations. This study included 83,856 PLHIV with 4,436 cancer diagnoses. Post-ADM diagnosis, 603 deaths occurred, of those, an ADM accounted for 292 (48%). Overall 467/847 (55%) and 74/189 (39%) deaths attributable to an NADM following non-viral and viral NADM diagnoses, respectively, were reported. The PLHIV diagnosed with liver, lung, and cervical cancer experienced a 5-year survival similar to that of general populations. PLHIV exhibited lower survival following Hodgkin's lymphoma diagnosis. Findings revealed that MR and causes of mortality differed by cancer type among ART-managed PLHIV diagnosed with cancer. For liver and lung cancers, the highest mortality was reported. Cancer, instead of AIDS, was more likely to be the reason for deaths that occurred within 5 years of NADM diagnoses.
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