High-density lipoprotein-cholesterol levels and risk of cancer in HIV-infected subjects: Data from the ICONA Foundation Cohort. Issue 36 (September 2016)

• Record Type: Journal Article
• Authors: Squillace, Nicola; Galli, Laura; Bandera, Alessandra; Castagna, Antonella; Madeddu, Giordano; Caramello, Pietro; Antinori, Andrea; Cattelan, Annamaria; Maggiolo, Franco; Cingolani, Antonella; Gori, Andrea; Monforte, Antonella d'Arminio
• Other Names: Rizzardini. Guiliano section editor.
• Is Part Of: Medicine. Volume 95:Issue 36(2016)
• Publication Date: 2016-09
• Subjects: AIDS-defining malignancies -- cancer -- HDL -- HIV -- non-AIDS-defining malignancies; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000004434
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: 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.