High-density lipoprotein-cholesterol levels and risk of cancer in HIV-infected subjects Data from the ICONA Foundation Cohort

Nicola Squillace, Laura Galli, Alessandra Bandera, Antonella Castagna, Giordano Madeddu, Pietro Caramello, Andrea Antinori, Annamaria Cattelan, Franco Maggiolo, Antonella Cingolani, Andrea Gori, Antonella D arminio Monforte

Research output: Contribution to journalArticlepeer-review

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 HIVpositive 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 (<39mg/dL in males or <49mg/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.

Original languageEnglish
Article numbere4434
JournalMedicine (United States)
Volume95
Issue number36
DOIs
Publication statusPublished - 2016

Keywords

  • AIDS-defining malignancies
  • Cancer
  • HDL
  • HIV
  • Non-AIDS-defining malignancies

ASJC Scopus subject areas

  • Medicine(all)

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