Infection-related and -unrelated malignancies, HIV and the aging population

L. Shepherd, Álvaro H. Borges, B. Ledergerber, P. Domingo, Antonella Castagna, J. Rockstroh, Brygida Knysz, J. Tomazic, I. Karpov, Ole Kirk, J. D. Lundgren, Amanda Mocroft, M. Losso, M. Kundro, N. Vetter, Robert Zangerle, Igor Karpov, A. Vassilenko, V. M. Mitsura, O. Suetnov & 206 others Nathan Clumeck, Stéphane De Wit, M. Delforge, E. Florence, L. Vandekerckhove, V. Hadziosmanovic, K. Kostov, J. Begovac, L. Machala, D. Jilich, D. Sedlacek, J. Nielsen, G. Kronborg, T. Benfield, M. Larsen, J. Gerstoft, T. Katzenstein, A. B E Hansen, P. Skinhøj, C. Pedersen, L. Ostergaard, Ulrik B. Dragsted, L. N. Nielsen, K. Zilmer, J. Smidt, M. Ristola, Christine Katlama, J. P. Viard, Pierre Marie Girard, P. Vanhems, C. Pradier, Murielle Mary Krause, D. Neau, C. Duvivier, J. K. Rockstroh, R. E. Schmidt, Jan Van Lunzen, O. Degen, H. J. Stellbrink, M. Bickel, J. R. Bogner, Gerd Fätkenheuer, J. Kosmidis, P. Gargalianos, G. Xylomenos, J. Perdios, H. Sambatakou, D. Banhegyi, M. Gottfredsson, F. Mulcahy, I. Yust, D. Turner, M. Burke, S. Pollack, G. Hassoun, H. Elinav, M. Haouzi, Antonella D’Arminio Monforte, R. Esposito, I. Mazeu, Cristina Mussini, C. Arici, R. Pristera, F. Mazzotta, Andrea Gabbuti, Vincenzo Vullo, Miriam Lichtner, A. Chirianni, E. Montesarchio, M. Gargiulo, G. D‘Offizi, Gianpiero D'Offizi, A. Antinori, Andrea Antinori, Adriano Lazzarin, Antonella Castagna, Nicola Gianotti, Annalisa Ridolfo, B. Rozentale, I. Zeltina, S. Chaplinskas, T. Staub, R. Hemmer, Peter Reiss, V. Ormaasen, A. Maeland, J. Bruun, B. Knysz, J. Gasiorowski, A. Horban, E. Bakowska, A. Grzeszczuk, R. Flisiak, A. Boron-Kaczmarska, M. Pynka, M. Parczewski, M. Beniowski, E. Mularska, H. Trocha, E. Jablonowska, E. Malolepsza, K. Wojcik, M. Doroana, L. Caldeira, K. Mansinho, F. Maltez, D. Duiculescu, A. Rakhmanova, A. Rakhmanova, S. Buzunova, I. Khromova, E. Kuzovatova, D. Jevtovic, M. Mokráš, D. Staneková, J. Tomazic, J. González-Lahoz, V. Soriano, P. Labarga, Santiago Moreno, J. M. Rodriguez, B. Clotet, A. Jou, R. Paredes, C. Tural, J. Puig, I. Bravo, J. M. Gatell, Jose Miro, Pere Domingo, M. Gutierrez, G. Mateo, M. A. Sambeat, J. Medrano, A. BlaxhultBlaxhult, L. Flamholc, A. Thalme, Anders Sönnerborg, B. Ledergerber, R. Weber, P. Francioli, M. Cavassini, B. Hirschel, E. Boffi, Hansjakob Furrer, Manuel Battegay, L. Elzi, P. Vernazza, E. Kravchenko, N. Chentsova, V. Frolov, G. Kutsyna, S. Servitskiy, A. Kuznetsova, G. Kyselyova, B. Gazzard, Anne M. Johnson, E. Simons, A. Phillips, Margaret Johnson, Amanda Mocroft, C. Orkin, Jonathan Weber, G. Scullard, Martin Fisher, C. Leen, J. M. Gatell, B. Gazzard, A. Horban, I. Karpov, Bruno Ledergerber, M. Losso, Antonella D’Arminio-Monforte, Court Pedersen, A. Rakhmanova, M. Ristola, J. Rockstroh, S. De Witt, Jens Lundgren, A. N. Phillips, Peter Reiss, Ole Kirk, Amanda Mocroft, A. Cozzi-Lepri, D. Grint, A. Schultze, L. Shepherd, D. Raben, D. Podlekareva, Jesper Kjaer, L. Peters, J. E. Nielsen, C. Matthews, A. H. Fischer, A. Bojesen, O. Kirk, Amanda Mocroft, Jesper Grarup, Peter Reiss, Alessandro Cozzi-Lepri, Rodolphe Thiebaut, J. Rockstroh, D. M. Burger, Roger Paredes, Jesper Kjaer, L. Peters

Research output: Contribution to journalArticle

Abstract

Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.

Original languageEnglish
Pages (from-to)590-600
Number of pages11
JournalHIV Medicine
Volume17
Issue number8
DOIs
Publication statusPublished - Sep 1 2016

Fingerprint

HIV
Infection
Population
Neoplasms
Incidence
Confidence Intervals
CD4 Lymphocyte Count
Smoking
Demography
Social Adjustment
HIV Infections
Lung Neoplasms

Keywords

  • aging
  • HIV
  • malignancies
  • virus-associated malignancies

ASJC Scopus subject areas

  • Health Policy
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Shepherd, L., Borges, Á. H., Ledergerber, B., Domingo, P., Castagna, A., Rockstroh, J., ... Peters, L. (2016). Infection-related and -unrelated malignancies, HIV and the aging population. HIV Medicine, 17(8), 590-600. https://doi.org/10.1111/hiv.12359

Infection-related and -unrelated malignancies, HIV and the aging population. / Shepherd, L.; Borges, Álvaro H.; Ledergerber, B.; Domingo, P.; Castagna, Antonella; Rockstroh, J.; Knysz, Brygida; Tomazic, J.; Karpov, I.; Kirk, Ole; Lundgren, J. D.; Mocroft, Amanda; Losso, M.; Kundro, M.; Vetter, N.; Zangerle, Robert; Karpov, Igor; Vassilenko, A.; Mitsura, V. M.; Suetnov, O.; Clumeck, Nathan; De Wit, Stéphane; Delforge, M.; Florence, E.; Vandekerckhove, L.; Hadziosmanovic, V.; Kostov, K.; Begovac, J.; Machala, L.; Jilich, D.; Sedlacek, D.; Nielsen, J.; Kronborg, G.; Benfield, T.; Larsen, M.; Gerstoft, J.; Katzenstein, T.; Hansen, A. B E; Skinhøj, P.; Pedersen, C.; Ostergaard, L.; Dragsted, Ulrik B.; Nielsen, L. N.; Zilmer, K.; Smidt, J.; Ristola, M.; Katlama, Christine; Viard, J. P.; Girard, Pierre Marie; Vanhems, P.; Pradier, C.; Krause, Murielle Mary; Neau, D.; Duvivier, C.; Rockstroh, J. K.; Schmidt, R. E.; Van Lunzen, Jan; Degen, O.; Stellbrink, H. J.; Bickel, M.; Bogner, J. R.; Fätkenheuer, Gerd; Kosmidis, J.; Gargalianos, P.; Xylomenos, G.; Perdios, J.; Sambatakou, H.; Banhegyi, D.; Gottfredsson, M.; Mulcahy, F.; Yust, I.; Turner, D.; Burke, M.; Pollack, S.; Hassoun, G.; Elinav, H.; Haouzi, M.; D’Arminio Monforte, Antonella; Esposito, R.; Mazeu, I.; Mussini, Cristina; Arici, C.; Pristera, R.; Mazzotta, F.; Gabbuti, Andrea; Vullo, Vincenzo; Lichtner, Miriam; Chirianni, A.; Montesarchio, E.; Gargiulo, M.; D‘Offizi, G.; D'Offizi, Gianpiero; Antinori, A.; Antinori, Andrea; Lazzarin, Adriano; Castagna, Antonella; Gianotti, Nicola; Ridolfo, Annalisa; Rozentale, B.; Zeltina, I.; Chaplinskas, S.; Staub, T.; Hemmer, R.; Reiss, Peter; Ormaasen, V.; Maeland, A.; Bruun, J.; Knysz, B.; Gasiorowski, J.; Horban, A.; Bakowska, E.; Grzeszczuk, A.; Flisiak, R.; Boron-Kaczmarska, A.; Pynka, M.; Parczewski, M.; Beniowski, M.; Mularska, E.; Trocha, H.; Jablonowska, E.; Malolepsza, E.; Wojcik, K.; Doroana, M.; Caldeira, L.; Mansinho, K.; Maltez, F.; Duiculescu, D.; Rakhmanova, A.; Rakhmanova, A.; Buzunova, S.; Khromova, I.; Kuzovatova, E.; Jevtovic, D.; Mokráš, M.; Staneková, D.; Tomazic, J.; González-Lahoz, J.; Soriano, V.; Labarga, P.; Moreno, Santiago; Rodriguez, J. M.; Clotet, B.; Jou, A.; Paredes, R.; Tural, C.; Puig, J.; Bravo, I.; Gatell, J. M.; Miro, Jose; Domingo, Pere; Gutierrez, M.; Mateo, G.; Sambeat, M. A.; Medrano, J.; BlaxhultBlaxhult, A.; Flamholc, L.; Thalme, A.; Sönnerborg, Anders; Ledergerber, B.; Weber, R.; Francioli, P.; Cavassini, M.; Hirschel, B.; Boffi, E.; Furrer, Hansjakob; Battegay, Manuel; Elzi, L.; Vernazza, P.; Kravchenko, E.; Chentsova, N.; Frolov, V.; Kutsyna, G.; Servitskiy, S.; Kuznetsova, A.; Kyselyova, G.; Gazzard, B.; Johnson, Anne M.; Simons, E.; Phillips, A.; Johnson, Margaret; Mocroft, Amanda; Orkin, C.; Weber, Jonathan; Scullard, G.; Fisher, Martin; Leen, C.; Gatell, J. M.; Gazzard, B.; Horban, A.; Karpov, I.; Ledergerber, Bruno; Losso, M.; D’Arminio-Monforte, Antonella; Pedersen, Court; Rakhmanova, A.; Ristola, M.; Rockstroh, J.; De Witt, S.; Lundgren, Jens; Phillips, A. N.; Reiss, Peter; Kirk, Ole; Mocroft, Amanda; Cozzi-Lepri, A.; Grint, D.; Schultze, A.; Shepherd, L.; Raben, D.; Podlekareva, D.; Kjaer, Jesper; Peters, L.; Nielsen, J. E.; Matthews, C.; Fischer, A. H.; Bojesen, A.; Kirk, O.; Mocroft, Amanda; Grarup, Jesper; Reiss, Peter; Cozzi-Lepri, Alessandro; Thiebaut, Rodolphe; Rockstroh, J.; Burger, D. M.; Paredes, Roger; Kjaer, Jesper; Peters, L.

In: HIV Medicine, Vol. 17, No. 8, 01.09.2016, p. 590-600.

Research output: Contribution to journalArticle

Shepherd, L, Borges, ÁH, Ledergerber, B, Domingo, P, Castagna, A, Rockstroh, J, Knysz, B, Tomazic, J, Karpov, I, Kirk, O, Lundgren, JD, Mocroft, A, Losso, M, Kundro, M, Vetter, N, Zangerle, R, Karpov, I, Vassilenko, A, Mitsura, VM, Suetnov, O, Clumeck, N, De Wit, S, Delforge, M, Florence, E, Vandekerckhove, L, Hadziosmanovic, V, Kostov, K, Begovac, J, Machala, L, Jilich, D, Sedlacek, D, Nielsen, J, Kronborg, G, Benfield, T, Larsen, M, Gerstoft, J, Katzenstein, T, Hansen, ABE, Skinhøj, P, Pedersen, C, Ostergaard, L, Dragsted, UB, Nielsen, LN, Zilmer, K, Smidt, J, Ristola, M, Katlama, C, Viard, JP, Girard, PM, Vanhems, P, Pradier, C, Krause, MM, Neau, D, Duvivier, C, Rockstroh, JK, Schmidt, RE, Van Lunzen, J, Degen, O, Stellbrink, HJ, Bickel, M, Bogner, JR, Fätkenheuer, G, Kosmidis, J, Gargalianos, P, Xylomenos, G, Perdios, J, Sambatakou, H, Banhegyi, D, Gottfredsson, M, Mulcahy, F, Yust, I, Turner, D, Burke, M, Pollack, S, Hassoun, G, Elinav, H, Haouzi, M, D’Arminio Monforte, A, Esposito, R, Mazeu, I, Mussini, C, Arici, C, Pristera, R, Mazzotta, F, Gabbuti, A, Vullo, V, Lichtner, M, Chirianni, A, Montesarchio, E, Gargiulo, M, D‘Offizi, G, D'Offizi, G, Antinori, A, Antinori, A, Lazzarin, A, Castagna, A, Gianotti, N, Ridolfo, A, Rozentale, B, Zeltina, I, Chaplinskas, S, Staub, T, Hemmer, R, Reiss, P, Ormaasen, V, Maeland, A, Bruun, J, Knysz, B, Gasiorowski, J, Horban, A, Bakowska, E, Grzeszczuk, A, Flisiak, R, Boron-Kaczmarska, A, Pynka, M, Parczewski, M, Beniowski, M, Mularska, E, Trocha, H, Jablonowska, E, Malolepsza, E, Wojcik, K, Doroana, M, Caldeira, L, Mansinho, K, Maltez, F, Duiculescu, D, Rakhmanova, A, Rakhmanova, A, Buzunova, S, Khromova, I, Kuzovatova, E, Jevtovic, D, Mokráš, M, Staneková, D, Tomazic, J, González-Lahoz, J, Soriano, V, Labarga, P, Moreno, S, Rodriguez, JM, Clotet, B, Jou, A, Paredes, R, Tural, C, Puig, J, Bravo, I, Gatell, JM, Miro, J, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, MA, Medrano, J, BlaxhultBlaxhult, A, Flamholc, L, Thalme, A, Sönnerborg, A, Ledergerber, B, Weber, R, Francioli, P, Cavassini, M, Hirschel, B, Boffi, E, Furrer, H, Battegay, M, Elzi, L, Vernazza, P, Kravchenko, E, Chentsova, N, Frolov, V, Kutsyna, G, Servitskiy, S, Kuznetsova, A, Kyselyova, G, Gazzard, B, Johnson, AM, Simons, E, Phillips, A, Johnson, M, Mocroft, A, Orkin, C, Weber, J, Scullard, G, Fisher, M, Leen, C, Gatell, JM, Gazzard, B, Horban, A, Karpov, I, Ledergerber, B, Losso, M, D’Arminio-Monforte, A, Pedersen, C, Rakhmanova, A, Ristola, M, Rockstroh, J, De Witt, S, Lundgren, J, Phillips, AN, Reiss, P, Kirk, O, Mocroft, A, Cozzi-Lepri, A, Grint, D, Schultze, A, Shepherd, L, Raben, D, Podlekareva, D, Kjaer, J, Peters, L, Nielsen, JE, Matthews, C, Fischer, AH, Bojesen, A, Kirk, O, Mocroft, A, Grarup, J, Reiss, P, Cozzi-Lepri, A, Thiebaut, R, Rockstroh, J, Burger, DM, Paredes, R, Kjaer, J & Peters, L 2016, 'Infection-related and -unrelated malignancies, HIV and the aging population', HIV Medicine, vol. 17, no. 8, pp. 590-600. https://doi.org/10.1111/hiv.12359
Shepherd L, Borges ÁH, Ledergerber B, Domingo P, Castagna A, Rockstroh J et al. Infection-related and -unrelated malignancies, HIV and the aging population. HIV Medicine. 2016 Sep 1;17(8):590-600. https://doi.org/10.1111/hiv.12359
Shepherd, L. ; Borges, Álvaro H. ; Ledergerber, B. ; Domingo, P. ; Castagna, Antonella ; Rockstroh, J. ; Knysz, Brygida ; Tomazic, J. ; Karpov, I. ; Kirk, Ole ; Lundgren, J. D. ; Mocroft, Amanda ; Losso, M. ; Kundro, M. ; Vetter, N. ; Zangerle, Robert ; Karpov, Igor ; Vassilenko, A. ; Mitsura, V. M. ; Suetnov, O. ; Clumeck, Nathan ; De Wit, Stéphane ; Delforge, M. ; Florence, E. ; Vandekerckhove, L. ; Hadziosmanovic, V. ; Kostov, K. ; Begovac, J. ; Machala, L. ; Jilich, D. ; Sedlacek, D. ; Nielsen, J. ; Kronborg, G. ; Benfield, T. ; Larsen, M. ; Gerstoft, J. ; Katzenstein, T. ; Hansen, A. B E ; Skinhøj, P. ; Pedersen, C. ; Ostergaard, L. ; Dragsted, Ulrik B. ; Nielsen, L. N. ; Zilmer, K. ; Smidt, J. ; Ristola, M. ; Katlama, Christine ; Viard, J. P. ; Girard, Pierre Marie ; Vanhems, P. ; Pradier, C. ; Krause, Murielle Mary ; Neau, D. ; Duvivier, C. ; Rockstroh, J. K. ; Schmidt, R. E. ; Van Lunzen, Jan ; Degen, O. ; Stellbrink, H. J. ; Bickel, M. ; Bogner, J. R. ; Fätkenheuer, Gerd ; Kosmidis, J. ; Gargalianos, P. ; Xylomenos, G. ; Perdios, J. ; Sambatakou, H. ; Banhegyi, D. ; Gottfredsson, M. ; Mulcahy, F. ; Yust, I. ; Turner, D. ; Burke, M. ; Pollack, S. ; Hassoun, G. ; Elinav, H. ; Haouzi, M. ; D’Arminio Monforte, Antonella ; Esposito, R. ; Mazeu, I. ; Mussini, Cristina ; Arici, C. ; Pristera, R. ; Mazzotta, F. ; Gabbuti, Andrea ; Vullo, Vincenzo ; Lichtner, Miriam ; Chirianni, A. ; Montesarchio, E. ; Gargiulo, M. ; D‘Offizi, G. ; D'Offizi, Gianpiero ; Antinori, A. ; Antinori, Andrea ; Lazzarin, Adriano ; Castagna, Antonella ; Gianotti, Nicola ; Ridolfo, Annalisa ; Rozentale, B. ; Zeltina, I. ; Chaplinskas, S. ; Staub, T. ; Hemmer, R. ; Reiss, Peter ; Ormaasen, V. ; Maeland, A. ; Bruun, J. ; Knysz, B. ; Gasiorowski, J. ; Horban, A. ; Bakowska, E. ; Grzeszczuk, A. ; Flisiak, R. ; Boron-Kaczmarska, A. ; Pynka, M. ; Parczewski, M. ; Beniowski, M. ; Mularska, E. ; Trocha, H. ; Jablonowska, E. ; Malolepsza, E. ; Wojcik, K. ; Doroana, M. ; Caldeira, L. ; Mansinho, K. ; Maltez, F. ; Duiculescu, D. ; Rakhmanova, A. ; Rakhmanova, A. ; Buzunova, S. ; Khromova, I. ; Kuzovatova, E. ; Jevtovic, D. ; Mokráš, M. ; Staneková, D. ; Tomazic, J. ; González-Lahoz, J. ; Soriano, V. ; Labarga, P. ; Moreno, Santiago ; Rodriguez, J. M. ; Clotet, B. ; Jou, A. ; Paredes, R. ; Tural, C. ; Puig, J. ; Bravo, I. ; Gatell, J. M. ; Miro, Jose ; Domingo, Pere ; Gutierrez, M. ; Mateo, G. ; Sambeat, M. A. ; Medrano, J. ; BlaxhultBlaxhult, A. ; Flamholc, L. ; Thalme, A. ; Sönnerborg, Anders ; Ledergerber, B. ; Weber, R. ; Francioli, P. ; Cavassini, M. ; Hirschel, B. ; Boffi, E. ; Furrer, Hansjakob ; Battegay, Manuel ; Elzi, L. ; Vernazza, P. ; Kravchenko, E. ; Chentsova, N. ; Frolov, V. ; Kutsyna, G. ; Servitskiy, S. ; Kuznetsova, A. ; Kyselyova, G. ; Gazzard, B. ; Johnson, Anne M. ; Simons, E. ; Phillips, A. ; Johnson, Margaret ; Mocroft, Amanda ; Orkin, C. ; Weber, Jonathan ; Scullard, G. ; Fisher, Martin ; Leen, C. ; Gatell, J. M. ; Gazzard, B. ; Horban, A. ; Karpov, I. ; Ledergerber, Bruno ; Losso, M. ; D’Arminio-Monforte, Antonella ; Pedersen, Court ; Rakhmanova, A. ; Ristola, M. ; Rockstroh, J. ; De Witt, S. ; Lundgren, Jens ; Phillips, A. N. ; Reiss, Peter ; Kirk, Ole ; Mocroft, Amanda ; Cozzi-Lepri, A. ; Grint, D. ; Schultze, A. ; Shepherd, L. ; Raben, D. ; Podlekareva, D. ; Kjaer, Jesper ; Peters, L. ; Nielsen, J. E. ; Matthews, C. ; Fischer, A. H. ; Bojesen, A. ; Kirk, O. ; Mocroft, Amanda ; Grarup, Jesper ; Reiss, Peter ; Cozzi-Lepri, Alessandro ; Thiebaut, Rodolphe ; Rockstroh, J. ; Burger, D. M. ; Paredes, Roger ; Kjaer, Jesper ; Peters, L. / Infection-related and -unrelated malignancies, HIV and the aging population. In: HIV Medicine. 2016 ; Vol. 17, No. 8. pp. 590-600.
@article{850a251d309544bc9e17b51f9cd7271e,
title = "Infection-related and -unrelated malignancies, HIV and the aging population",
abstract = "Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60{\%}); IURMs: 255 (40{\%})]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95{\%} confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95{\%} CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95{\%} CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29{\%} over a 5-year period from 3.1 (95{\%} CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44{\%} from 4.1 (95{\%} CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.",
keywords = "aging, HIV, malignancies, virus-associated malignancies",
author = "L. Shepherd and Borges, {{\'A}lvaro H.} and B. Ledergerber and P. Domingo and Antonella Castagna and J. Rockstroh and Brygida Knysz and J. Tomazic and I. Karpov and Ole Kirk and Lundgren, {J. D.} and Amanda Mocroft and M. Losso and M. Kundro and N. Vetter and Robert Zangerle and Igor Karpov and A. Vassilenko and Mitsura, {V. M.} and O. Suetnov and Nathan Clumeck and {De Wit}, St{\'e}phane and M. Delforge and E. Florence and L. Vandekerckhove and V. Hadziosmanovic and K. Kostov and J. Begovac and L. Machala and D. Jilich and D. Sedlacek and J. Nielsen and G. Kronborg and T. Benfield and M. Larsen and J. Gerstoft and T. Katzenstein and Hansen, {A. B E} and P. Skinh{\o}j and C. Pedersen and L. Ostergaard and Dragsted, {Ulrik B.} and Nielsen, {L. N.} and K. Zilmer and J. Smidt and M. Ristola and Christine Katlama and Viard, {J. P.} and Girard, {Pierre Marie} and P. Vanhems and C. Pradier and Krause, {Murielle Mary} and D. Neau and C. Duvivier and Rockstroh, {J. K.} and Schmidt, {R. E.} and {Van Lunzen}, Jan and O. Degen and Stellbrink, {H. J.} and M. Bickel and Bogner, {J. R.} and Gerd F{\"a}tkenheuer and J. Kosmidis and P. Gargalianos and G. Xylomenos and J. Perdios and H. Sambatakou and D. Banhegyi and M. Gottfredsson and F. Mulcahy and I. Yust and D. Turner and M. Burke and S. Pollack and G. Hassoun and H. Elinav and M. Haouzi and {D’Arminio Monforte}, Antonella and R. Esposito and I. Mazeu and Cristina Mussini and C. Arici and R. Pristera and F. Mazzotta and Andrea Gabbuti and Vincenzo Vullo and Miriam Lichtner and A. Chirianni and E. Montesarchio and M. Gargiulo and G. D‘Offizi and Gianpiero D'Offizi and A. Antinori and Andrea Antinori and Adriano Lazzarin and Antonella Castagna and Nicola Gianotti and Annalisa Ridolfo and B. Rozentale and I. Zeltina and S. Chaplinskas and T. Staub and R. Hemmer and Peter Reiss and V. Ormaasen and A. Maeland and J. Bruun and B. Knysz and J. Gasiorowski and A. Horban and E. Bakowska and A. Grzeszczuk and R. Flisiak and A. Boron-Kaczmarska and M. Pynka and M. Parczewski and M. Beniowski and E. Mularska and H. Trocha and E. Jablonowska and E. Malolepsza and K. Wojcik and M. Doroana and L. Caldeira and K. Mansinho and F. Maltez and D. Duiculescu and A. Rakhmanova and A. Rakhmanova and S. Buzunova and I. Khromova and E. Kuzovatova and D. Jevtovic and M. Mokr{\'a}š and D. Stanekov{\'a} and J. Tomazic and J. Gonz{\'a}lez-Lahoz and V. Soriano and P. Labarga and Santiago Moreno and Rodriguez, {J. M.} and B. Clotet and A. Jou and R. Paredes and C. Tural and J. Puig and I. Bravo and Gatell, {J. M.} and Jose Miro and Pere Domingo and M. Gutierrez and G. Mateo and Sambeat, {M. A.} and J. Medrano and A. BlaxhultBlaxhult and L. Flamholc and A. Thalme and Anders S{\"o}nnerborg and B. Ledergerber and R. Weber and P. Francioli and M. Cavassini and B. Hirschel and E. Boffi and Hansjakob Furrer and Manuel Battegay and L. Elzi and P. Vernazza and E. Kravchenko and N. Chentsova and V. Frolov and G. Kutsyna and S. Servitskiy and A. Kuznetsova and G. Kyselyova and B. Gazzard and Johnson, {Anne M.} and E. Simons and A. Phillips and Margaret Johnson and Amanda Mocroft and C. Orkin and Jonathan Weber and G. Scullard and Martin Fisher and C. Leen and Gatell, {J. M.} and B. Gazzard and A. Horban and I. Karpov and Bruno Ledergerber and M. Losso and Antonella D’Arminio-Monforte and Court Pedersen and A. Rakhmanova and M. Ristola and J. Rockstroh and {De Witt}, S. and Jens Lundgren and Phillips, {A. N.} and Peter Reiss and Ole Kirk and Amanda Mocroft and A. Cozzi-Lepri and D. Grint and A. Schultze and L. Shepherd and D. Raben and D. Podlekareva and Jesper Kjaer and L. Peters and Nielsen, {J. E.} and C. Matthews and Fischer, {A. H.} and A. Bojesen and O. Kirk and Amanda Mocroft and Jesper Grarup and Peter Reiss and Alessandro Cozzi-Lepri and Rodolphe Thiebaut and J. Rockstroh and Burger, {D. M.} and Roger Paredes and Jesper Kjaer and L. Peters",
year = "2016",
month = "9",
day = "1",
doi = "10.1111/hiv.12359",
language = "English",
volume = "17",
pages = "590--600",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Blackwell Publishing Ltd",
number = "8",

}

TY - JOUR

T1 - Infection-related and -unrelated malignancies, HIV and the aging population

AU - Shepherd, L.

AU - Borges, Álvaro H.

AU - Ledergerber, B.

AU - Domingo, P.

AU - Castagna, Antonella

AU - Rockstroh, J.

AU - Knysz, Brygida

AU - Tomazic, J.

AU - Karpov, I.

AU - Kirk, Ole

AU - Lundgren, J. D.

AU - Mocroft, Amanda

AU - Losso, M.

AU - Kundro, M.

AU - Vetter, N.

AU - Zangerle, Robert

AU - Karpov, Igor

AU - Vassilenko, A.

AU - Mitsura, V. M.

AU - Suetnov, O.

AU - Clumeck, Nathan

AU - De Wit, Stéphane

AU - Delforge, M.

AU - Florence, E.

AU - Vandekerckhove, L.

AU - Hadziosmanovic, V.

AU - Kostov, K.

AU - Begovac, J.

AU - Machala, L.

AU - Jilich, D.

AU - Sedlacek, D.

AU - Nielsen, J.

AU - Kronborg, G.

AU - Benfield, T.

AU - Larsen, M.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B E

AU - Skinhøj, P.

AU - Pedersen, C.

AU - Ostergaard, L.

AU - Dragsted, Ulrik B.

AU - Nielsen, L. N.

AU - Zilmer, K.

AU - Smidt, J.

AU - Ristola, M.

AU - Katlama, Christine

AU - Viard, J. P.

AU - Girard, Pierre Marie

AU - Vanhems, P.

AU - Pradier, C.

AU - Krause, Murielle Mary

AU - Neau, D.

AU - Duvivier, C.

AU - Rockstroh, J. K.

AU - Schmidt, R. E.

AU - Van Lunzen, Jan

AU - Degen, O.

AU - Stellbrink, H. J.

AU - Bickel, M.

AU - Bogner, J. R.

AU - Fätkenheuer, Gerd

AU - Kosmidis, J.

AU - Gargalianos, P.

AU - Xylomenos, G.

AU - Perdios, J.

AU - Sambatakou, H.

AU - Banhegyi, D.

AU - Gottfredsson, M.

AU - Mulcahy, F.

AU - Yust, I.

AU - Turner, D.

AU - Burke, M.

AU - Pollack, S.

AU - Hassoun, G.

AU - Elinav, H.

AU - Haouzi, M.

AU - D’Arminio Monforte, Antonella

AU - Esposito, R.

AU - Mazeu, I.

AU - Mussini, Cristina

AU - Arici, C.

AU - Pristera, R.

AU - Mazzotta, F.

AU - Gabbuti, Andrea

AU - Vullo, Vincenzo

AU - Lichtner, Miriam

AU - Chirianni, A.

AU - Montesarchio, E.

AU - Gargiulo, M.

AU - D‘Offizi, G.

AU - D'Offizi, Gianpiero

AU - Antinori, A.

AU - Antinori, Andrea

AU - Lazzarin, Adriano

AU - Castagna, Antonella

AU - Gianotti, Nicola

AU - Ridolfo, Annalisa

AU - Rozentale, B.

AU - Zeltina, I.

AU - Chaplinskas, S.

AU - Staub, T.

AU - Hemmer, R.

AU - Reiss, Peter

AU - Ormaasen, V.

AU - Maeland, A.

AU - Bruun, J.

AU - Knysz, B.

AU - Gasiorowski, J.

AU - Horban, A.

AU - Bakowska, E.

AU - Grzeszczuk, A.

AU - Flisiak, R.

AU - Boron-Kaczmarska, A.

AU - Pynka, M.

AU - Parczewski, M.

AU - Beniowski, M.

AU - Mularska, E.

AU - Trocha, H.

AU - Jablonowska, E.

AU - Malolepsza, E.

AU - Wojcik, K.

AU - Doroana, M.

AU - Caldeira, L.

AU - Mansinho, K.

AU - Maltez, F.

AU - Duiculescu, D.

AU - Rakhmanova, A.

AU - Rakhmanova, A.

AU - Buzunova, S.

AU - Khromova, I.

AU - Kuzovatova, E.

AU - Jevtovic, D.

AU - Mokráš, M.

AU - Staneková, D.

AU - Tomazic, J.

AU - González-Lahoz, J.

AU - Soriano, V.

AU - Labarga, P.

AU - Moreno, Santiago

AU - Rodriguez, J. M.

AU - Clotet, B.

AU - Jou, A.

AU - Paredes, R.

AU - Tural, C.

AU - Puig, J.

AU - Bravo, I.

AU - Gatell, J. M.

AU - Miro, Jose

AU - Domingo, Pere

AU - Gutierrez, M.

AU - Mateo, G.

AU - Sambeat, M. A.

AU - Medrano, J.

AU - BlaxhultBlaxhult, A.

AU - Flamholc, L.

AU - Thalme, A.

AU - Sönnerborg, Anders

AU - Ledergerber, B.

AU - Weber, R.

AU - Francioli, P.

AU - Cavassini, M.

AU - Hirschel, B.

AU - Boffi, E.

AU - Furrer, Hansjakob

AU - Battegay, Manuel

AU - Elzi, L.

AU - Vernazza, P.

AU - Kravchenko, E.

AU - Chentsova, N.

AU - Frolov, V.

AU - Kutsyna, G.

AU - Servitskiy, S.

AU - Kuznetsova, A.

AU - Kyselyova, G.

AU - Gazzard, B.

AU - Johnson, Anne M.

AU - Simons, E.

AU - Phillips, A.

AU - Johnson, Margaret

AU - Mocroft, Amanda

AU - Orkin, C.

AU - Weber, Jonathan

AU - Scullard, G.

AU - Fisher, Martin

AU - Leen, C.

AU - Gatell, J. M.

AU - Gazzard, B.

AU - Horban, A.

AU - Karpov, I.

AU - Ledergerber, Bruno

AU - Losso, M.

AU - D’Arminio-Monforte, Antonella

AU - Pedersen, Court

AU - Rakhmanova, A.

AU - Ristola, M.

AU - Rockstroh, J.

AU - De Witt, S.

AU - Lundgren, Jens

AU - Phillips, A. N.

AU - Reiss, Peter

AU - Kirk, Ole

AU - Mocroft, Amanda

AU - Cozzi-Lepri, A.

AU - Grint, D.

AU - Schultze, A.

AU - Shepherd, L.

AU - Raben, D.

AU - Podlekareva, D.

AU - Kjaer, Jesper

AU - Peters, L.

AU - Nielsen, J. E.

AU - Matthews, C.

AU - Fischer, A. H.

AU - Bojesen, A.

AU - Kirk, O.

AU - Mocroft, Amanda

AU - Grarup, Jesper

AU - Reiss, Peter

AU - Cozzi-Lepri, Alessandro

AU - Thiebaut, Rodolphe

AU - Rockstroh, J.

AU - Burger, D. M.

AU - Paredes, Roger

AU - Kjaer, Jesper

AU - Peters, L.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.

AB - Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.

KW - aging

KW - HIV

KW - malignancies

KW - virus-associated malignancies

UR - http://www.scopus.com/inward/record.url?scp=84983565599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983565599&partnerID=8YFLogxK

U2 - 10.1111/hiv.12359

DO - 10.1111/hiv.12359

M3 - Article

VL - 17

SP - 590

EP - 600

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 8

ER -