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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Cancer incidence and mortality for all causes in HIV-infected patients over a quarter century: a multicentre cohort study

Authors: Elena Raffetti, Laura Albini, Daria Gotti, Daniela Segala, Franco Maggiolo, Elisa di Filippo, Annalisa Saracino, Nicoletta Ladisa, Giuseppe Lapadula, Chiara Fornabaio, Filippo Castelnuovo, Salvatore Casari, Massimiliano Fabbiani, Piera Pierotti, Francesco Donato, Eugenia Quiros-Roldan, MASTER Cohort

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

We aimed to assess cancer incidence and mortality for all-causes and factors related to risk of death in an Italian cohort of HIV infected unselected patients as compared to the general population.

Methods

We conducted a retrospective (1986–2012) cohort study on 16 268 HIV infected patients enrolled in the MASTER cohort. The standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) were computed using cancer incidence rates of Italian Cancer Registries and official national data for overall mortality. The risk factors for death from all causes were assessed using Poisson regression models.

Results

1,195 cancer cases were diagnosed from 1986 to 2012: 700 AIDS-defining-cancers (ADCs) and 495 non-AIDS-defining-cancers (NADCs). ADC incidence was much higher than the Italian population (SIR = 30.8, 95% confidence interval 27.9-34.0) whereas NADC incidence was similar to the general population (SIR = 0.9, 95% CI 0.8-1.1). The SMR for all causes was 11.6 (11.1-12.0) in the period, and it decreased over time, mainly after 1996, up to 3.53 (2.5-4.8) in 2012. Male gender, year of enrolment before 1993, older age at enrolment, intravenous drug use, low CD4 cell count, AIDS event, cancer occurrence and the absence of antiretroviral therapy were all associated independently with risk of death.

Conclusions

In HIV infected patients, ADC but not NADC incidence rates were higher than the general population. Although overall mortality in HIV infected subjects decreased over time, it is about three-fold higher than the general population at present.
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Metadata
Title
Cancer incidence and mortality for all causes in HIV-infected patients over a quarter century: a multicentre cohort study
Authors
Elena Raffetti
Laura Albini
Daria Gotti
Daniela Segala
Franco Maggiolo
Elisa di Filippo
Annalisa Saracino
Nicoletta Ladisa
Giuseppe Lapadula
Chiara Fornabaio
Filippo Castelnuovo
Salvatore Casari
Massimiliano Fabbiani
Piera Pierotti
Francesco Donato
Eugenia Quiros-Roldan
MASTER Cohort
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1565-0

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