Cancers attributable to infections among adults with HIV in the United States. (23rd October 2015)

• Record Type: Journal Article
• Authors: de Martel, Catherine; Shiels, Meredith S.; Franceschi, Silvia; Simard, Edgar P.; Vignat, Jérôme; Hall, H. Irene; Engels, Eric A.; Plummer, Martyn
• Is Part Of: AIDS. Volume 29:Number 16(2015)
• Publication Date: 2015-10-23
• Subjects: AIDS -- attributable fraction -- cancer -- HIV -- infection -- United States; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000000808
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: HIV-infected people are at increased risk of cancers of infectious origin. We estimated the burden of cancer attributable to infections among HIV-infected people in the United States in 2008. Design: Incidence rates for cancer sites associated with infections were estimated from record linkage between HIV/AIDS registries and cancer registries. Methods: Rates were applied to estimates of the population living with diagnosed HIV in the United States in 2008 to obtain the number of incident cancer cases. Site-specific attributable fractions and corresponding 95% confidence intervals (CIs) were estimated from infection prevalence among cancer cases. Infection prevalence data were derived from literature review of case series. Results: Of an estimated 6200 incident cancer cases (95% CI 6000–6500), 2500 (95% CI 2400–2700) were attributable to infection (attributable fraction = 40%, 95% CI 39–42). The most important infections were Kaposi sarcoma herpes virus, Epstein–Barr virus, and human papillomavirus, which together were responsible for 2200 new cancer cases (95% CI 2100–2400), mainly Kaposi sarcoma, lymphomas, and ano-genital cancers. The attributable fraction in HIV-infected people was highest in the age group 20–29 years (69%, 95% CI 65–72). MSM were the HIV transmission group with the highest attributable fraction (48%, 95% CI 46–50), due to the high incidence of both Kaposi sarcoma and anal cancer. Conclusion: The very high fraction of cancer attributable to infection in HIV-infected people points to special opportunities to prevent these cancers, that is, avoidance, detection, and early treatment of cancer-associated infections, and universal early detection and uninterrupted treatment of HIV infection to avoid immunosuppression. Abstract : Supplemental Digital Content is available in the text