Non-AIDS Defining Cancer Mortality: Emerging Patterns in the Late HAART Era

Antonella Zucchetto, Saverio Virdone, Martina Taborelli, Enrico Grande, Laura Camoni, Marilena Pappagallo, Vincenza Regine, Francesco Grippo, Jerry Polesel, Luigino Dal Maso, Barbara Suligoi, Luisa Frova, Diego Serraino

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BACKGROUND.: Non-AIDS defining cancers (non-ADCs) have become the leading non-AIDS-related cause of death among people with HIV/AIDS. We aimed to quantify the excess risk of cancer-related deaths among Italian people with AIDS (PWA), as compared to people without AIDS (non-PWA). METHODS.: A nationwide, population-based, retrospective cohort study was carried out among 5285 Italian PWA, aged 15-74 years, diagnosed between 2006 and 2011. Date of death and multiple-cause-of-death (MCoD) data were retrieved up to December 2011. Excess mortality, as compared to non-PWA, was estimated using sex- and age-standardized mortality ratios (SMRs) and corresponding 95% confidence intervals (CIs). RESULTS.: Among 1229 deceased PWA, 10.3% reported non-ADCs in the death certificate, including lung (3.1%) and liver (1.4%) cancers. A 7.3-fold (95% CI: 6.1-8.7) excess mortality was observed for all non-ADCs combined. Statistically significant SMRs emerged for specific non-ADCs, i.e., anus (5 deaths, SMR=227.6, 95% CI: 73.9-531.0), Hodgkin lymphoma (12 deaths, SMR=122.0, 95% CI: 63.0-213.0), unspecified uterus (4 deaths, SMR=52.5, 95% CI: 14.3-135.0, liver (17 deaths, SMR=13.2, 95% CI: 7.7-21.1), skin melanoma (4 deaths, SMR=10.9, 95% CI: 3.0-27.8), lung (38 deaths, SMR=8.0, 95% CI: 5.7-11.0), head and neck (9 deaths, SMR=7.8, 95% CI: 3.6-14.9), leukemia (5 deaths, SMR=7.6, 95% CI: 2.4-17.7), and colon-rectum (10 deaths, SMR=5.4, 95% CI: 2.6-10.0). SMRs for non-ADCs were particularly elevated among PWA infected through injecting drug use. CONCLUSION.: This population-based study documented extremely elevated risks of death for non-ADCs among PWA. These findings stress the need of preventive interventions for both virus-related and non virus-related cancers among HIV-infected individuals.

Original languageEnglish
Pages (from-to)190-196
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Publication statusPublished - 2016

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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