PMID- 24681415
OWN - NLM
STAT- MEDLINE
DCOM- 20150518
LR  - 20240217
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 28
IP  - 7
DP  - 2014 Apr 24
TI  - Relationship of immunologic response to antiretroviral therapy with non-AIDS 
      defining cancer incidence.
PG  - 979-87
LID - 10.1097/QAD.0000000000000167 [doi]
AB  - OBJECTIVE: To estimate the association between immunologic response to 
      antiretroviral therapy (ART) and non-AIDS defining cancer (NADC) incidence in 
      HIV-infected patients. DESIGN: A prospective cohort including patients with at 
      least 1 cell/mul CD4 cell count and HIV-1 RNA measure after ART initiation between 
      1996 and 2011 in the Centers for AIDS Research Network of Integrated Clinical 
      Systems, a collaboration of eight HIV clinics at major academic medical centres 
      in the United States. METHODS: Measures of immunologic response were 6-month CD4 
      post-ART, latest CD4 and CD4 count-years, a cumulative measure of CD4 
      lymphopenia. Cox regression with inverse probability-of-exposure weights was used 
      to calculate adjusted hazard ratios of virus-related and virus-unrelated NADC 
      incidence. RESULTS: Among 9389 patients at ART initiation, median CD4 cell count 
      was 200 cells/mul [interquartile range (IQR) 60-332)], and median HIV-1 RNA was 
      4.8 log10 copies/ml (IQR 4.3-5.4). Median follow-up was 3.3 years (IQR 1.5-6.5). 
      After 6 months of ART, median CD4 cell count was 304 cells/mul (IQR 163-469). One 
      hundred and sixty-four NADCs were diagnosed during study follow-up, 65 (40%) 
      considered virus-related. Virus-related NADCs were inversely associated with 
      6-month CD4 cell count (hazard ratio per 100 cells/mul increase=0.71), latest CD4 
      cell count (hazard ratio per 100 cells/mul increase=0.70) and CD4 cell count-years 
      (hazard ratio per 200 cell-years/mul increase=0.91) independent of CD4 cell count 
      at ART initiation, age and HIV-1 RNA response. No associations were found with 
      virus-unrelated NADCs. CONCLUSION: Poor CD4 cell count response was strongly 
      associated with virus-related NADC incidence, suggesting an important role for 
      T-cell mediated immunity in pathogenesis. Lower CD4 cell count proximal to cancer 
      diagnosis may be a result of subclinical cancer. Intensified cancer screening 
      should be considered for patients on ART with low CD4 cell counts.
FAU - Yanik, Elizabeth L
AU  - Yanik EL
AD  - aUniversity of North Carolina, Chapel Hill, North Carolina bNorthwestern 
      University, Chicago, Illinois cUniversity of Washington, Seattle, Washington 
      dUniversity of Alabama, Birmingham, Alabama eJohns Hopkins University, Baltimore, 
      Maryland fUniversity of California, San Diego gUniversity of California, San 
      Francisco, California, USA.
FAU - Napravnik, Sonia
AU  - Napravnik S
FAU - Cole, Stephen R
AU  - Cole SR
FAU - Achenbach, Chad J
AU  - Achenbach CJ
FAU - Gopal, Satish
AU  - Gopal S
FAU - Dittmer, Dirk P
AU  - Dittmer DP
FAU - Olshan, Andrew F
AU  - Olshan AF
FAU - Kitahata, Mari M
AU  - Kitahata MM
FAU - Mugavero, Michael J
AU  - Mugavero MJ
FAU - Saag, Michael
AU  - Saag M
FAU - Moore, Richard D
AU  - Moore RD
FAU - Mathews, W Christopher
AU  - Mathews WC
FAU - Hunt, Peter
AU  - Hunt P
FAU - Eron, Joseph J
AU  - Eron JJ
LA  - eng
GR  - T32 AI007001/AI/NIAID NIH HHS/United States
GR  - U01 DA036935/DA/NIDA NIH HHS/United States
GR  - P30-AI50410/AI/NIAID NIH HHS/United States
GR  - U01 AI069918/AI/NIAID NIH HHS/United States
GR  - 5T32AI007001-35/AI/NIAID NIH HHS/United States
GR  - U01 CA121947/CA/NCI NIH HHS/United States
GR  - P30 AI050410/AI/NIAID NIH HHS/United States
GR  - R24-AI067039/AI/NIAID NIH HHS/United States
GR  - K01 TW009488/TW/FIC NIH HHS/United States
GR  - T32 AI007140/AI/NIAID NIH HHS/United States
GR  - P30 CA016086/CA/NCI NIH HHS/United States
GR  - R01-DE018304/DE/NIDCR NIH HHS/United States
GR  - R01 DE018304/DE/NIDCR NIH HHS/United States
GR  - P30-CA016086/CA/NCI NIH HHS/United States
GR  - UO1 CA121947/CA/NCI NIH HHS/United States
GR  - R24 AI067039/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (RNA, Viral)
SB  - IM
MH  - Acquired Immunodeficiency Syndrome/*drug therapy/*immunology
MH  - Adolescent
MH  - Adult
MH  - Anti-Retroviral Agents/*therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*methods
MH  - CD4 Lymphocyte Count
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*epidemiology
MH  - Prospective Studies
MH  - RNA, Viral/blood
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC4040952
MID - NIHMS587183
COIS- All other authors have no conflicts of interest to declare.
EDAT- 2014/04/01 06:00
MHDA- 2015/05/20 06:00
PMCR- 2015/04/24
CRDT- 2014/04/01 06:00
PHST- 2014/04/01 06:00 [entrez]
PHST- 2014/04/01 06:00 [pubmed]
PHST- 2015/05/20 06:00 [medline]
PHST- 2015/04/24 00:00 [pmc-release]
AID - 10.1097/QAD.0000000000000167 [doi]
PST - ppublish
SO  - AIDS. 2014 Apr 24;28(7):979-87. doi: 10.1097/QAD.0000000000000167.