@article{176d03aedefe46458aef94ea2bd9bc3a,
title = "Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival: A cohort study",
abstract = "Background: Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.Methods: Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.Results: Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.Conclusions: The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC.",
keywords = "HIV, Incidence, Non-AIDS defining cancers, Prognosis, Trends",
author = "{D:A:D study group} and Worm, {Signe W.} and Mark Bower and Peter Reiss and Fabrice Bonnet and Matthew Law and Gerd F{\"a}tkenheuer and {d'Arminio Monforte}, Antonella and Abrams, {Donald I.} and Andrew Grulich and Eric Fontas and Ole Kirk and Hansjakob Furrer and Wit, {Stephane D.} and Andrew Phillips and Lundgren, {Jens D.} and Sabin, {Caroline A.} and D. Butcher and M. Delforge and I. Fanti and X. Franquet and S. Geffard and L. Gras and J. Helweg-Larsen and M. Hillebregt and D. Kamara and J. Kjaer and E. Krum and H. McManus and P. Meidahl and A. Mocroft and J. Nielsen and W. Powderl and M. Rickenbach and R. Rode and L. Ryom and {Salb{\o}l Brandt}, R. and {Schmidt Iversen}, J. and N. Shortman and Geerlings, {S. E.} and Kuijpers, {T. W.} and D. Pajkrt and Scherpbier, {H. J.} and Mulder, {J. W.} and Peters, {E. J.G.} and Bierman, {W. F.W.} and Claessen, {F. A.P.} and Danner, {S. A.} and Perenboom, {R. M.} and {de Vocht}, J. and {van Agtmael}, {M. A.} and {AUTHOR GROUP} and W. Powderly and C. Smith and J. Tverland and Prins, {J. M.} and K. Boer and {van der Meer}, {J. T. M.} and Wit, {F. W. M. N.} and Godfried, {M. H.} and {van der Poll}, T. and Nellen, {F. J. B.} and Lange, {J. M. A.} and {van Vugt}, M. and {van der Valk}, M.",
note = "Funding Information: This work was supported by the Highly Active Antiretroviral Therapy Oversight Committee (HAART-OC), a collaborative committee with representation from academic institutions, the European Agency for the Evaluation of Medicinal Products, the United States Food and Drug Administration, the patient community, and all pharmaceutical companies with licensed anti-HIV drugs in the European Union: Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals Inc., Bristol-Myers Squibb, Gilead Sciences Inc., Viiv Healthcare, Merck & Co Inc., Pfizer Inc, F. Hoffman-LaRoche Ltd and Janssen Pharmaceuticals. Supported by a grant [grant number CURE/97-46486] from the Health Insurance Fund Council, Amstelveen, the Netherlands, to the AIDS Therapy Evaluation Project Netherlands (ATHENA); by a grant from the Agence Nationale de Recherches sur le SIDA [grant number Action Coordonn{\'e}e no.7, Cohortes], to the Aquitaine Cohort; The Australian HIV Observational Database (AHOD) is funded as part of the Asia Pacific HIV Observational Database, a program of The Foundation for AIDS Research, amfAR, and is supported in part by a grant from the U.S. National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases (NIAID) [grant number U01-AI069907] and by unconditional grants from Merck Sharp & Dohme; Gilead Sciences; Bristol-Myers Squibb; Boehringer Ingelheim Pharmaceuticals Inc.; Roche; Pfizer; GlaxoSmithKline; Janssen Pharmaceuticals. The Kirby Institute is funded by The Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales. By grants from the Fondo de Investigaci{\'o}n Sanitaria [grant number FIS 99/0887] and Fundaci{\'o}n para la Investigaci{\'o}n y la Prevenci{\'o}n del SIDA en Espan{\~a} [grant number FIPSE 3171/00], to the Barcelona Antiretroviral Surveillance Study (BASS); by the National Institute of Allergy and Infectious Diseases, National Institutes of Health [grants number 5U01AI042170-10 , 5U01AI046362-03], to the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA); by grants from the BIOMED 1 [grant number CT94-1637] and BIOMED 2 [grant number CT97-2713] programs and the fifth framework program [grant number QLK2-2000-00773] of the European Commission and grants from Bristol-Myers Squibb, GlaxoSmithKline, Boehringer Ingelheim Pharmaceuticals Inc., and Roche, to the EuroSIDA study; by unrestricted educational grants of Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences Inc., GlaxoSmithKline, Pfizer Inc., Janssen Pharmaceuticals to the Italian Cohort Naive to Antiretrovirals (The ICONA Foundation); and by a grant from the Swiss National Science Foundation, to the Swiss HIV Cohort Study (SHCS). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. Funding Information: SWW was supported by the Danish Research Council. Grant number 09–070575. Part of the data included in this manuscript has been presented as an oral presentation at EACS, Belgrade, Serbia October 2011.",
year = "2013",
month = oct,
day = "9",
doi = "https://doi.org/10.1186/1471-2334-13-471",
language = "English",
volume = "13",
pages = "471",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",
number = "1",
}