There is a higher risk of some non-AIDS-defining cancers in people with HIV over 50 years

Cancer and non-AIDS defining cancer

Colón, breast and prostate cancer less frequent in people with HIV

CancerThe risk of multiple cancers increases with age for the seropositive elderly, from researchers in the United States report in Clinical Infectious Diseases. HIV-positive individuals with 50 years or older had a significantly higher incidence of numerous cancers, including several that are not normally HIV-related. Or AIDS. Although the incidence of some of these malignancies has slowed with advancing age, the absolute risk of anal, pulmonary, hepatic, oral and throat cancer has increased as people with HIV have aged. The risk of cancer was higher within five years from the diagnosis of HIV infection, underlining the importance of the alert for the detection and immediate treatment of HIV infection which, in my opinion, should be a urgent about PEP (or is the PEP a medical emergency because it can prevent * another break in the troubled (...) box of our Country?). Forgive me, I am somewhat apocryphal ...

The researchers found that aging itself has not resulted in an increased risk of cancer for people with HIV compared to the general population, suggesting that the higher the prevalence of risk and factors such as smoking, alcohol consumption and cancer-causing viral infections are responsible by the increased risk of some cancers in the elderly with HIV.

"We observed that the risk of cancer was high in older PLHA [people living with HIV or AIDS] compared to the general population, although the perennial risk of increased cancer risk has slowed with age," the authors write. "However, EARs * Acronym in English * [absolute risk excess], which measure the absolute risk and therefore reflects the number of excess cases of cancer occurring among PLHA (People Living with HIV or AIDS), increased with the advancement of age for some NADCs (non-AIDS defining cancers). "

The development of effective and safe antiretroviral therapy means that most people with HIV can now have a life expectancy at later ages. (* Yes, we would die like flies and although I do not feel exactly how you feel this my friend, whose name I will not say, and who should be in the 55 house, he says that the body and the disposition is of 80 - What quality of life are creating for us, because it is not to survive, is to live, and to live And do not dare call me an ingrate ...).

Diseases of aging - including certain cancers - are now a major cause of severe illness and death among people with HIV.

1As well as the aging process in general, among a number of factors, they contribute to the increased risk of cancers seen in older people living with HIV, including those related to HIV infection and / or immunosuppression, co-infection with certain cancerous viruses, such as HCV (Hepatitis C virus that is also sexually transmitted - another reason to use condoms, and lifestyle factors such as smoking.

Researchers in the United States wanted to measure the risk of cancer among HIV-positive people aged 50 or older. They therefore designed a study comparing the risk of cancer among people with HIV and individuals in the general population of the United States.

Both groups of cancers, AIDS-defining (Kaposi's sarcoma, non-Hodgkin's lymphoma, cervical cancers) and non-AIDS (anal, lung, liver, oral / throat, breast, prostate and colon) .

The researchers initially compared cancer incidence rates among people with HIV and the general population by calculating and standardizing the Incidence Ratio (SIRs), a measure of risk that takes into account the relative distributions in the population of people of different ages. They also calculated EARs, or the excess risk of developing cancer for a person with HIV.

Cancer risks in people with HIV have been calculated according to age (50-59, 60-69, 70 or older), AIDS diagnosis and time since HIV diagnosis.
The population studied consisted of 183.542 people enrolled in the HIV / AIDS Cancer Match study. These individuals received care between introducing effective HIV treatment in 1996 and 2012 and contributed a statistical total of 928.194 person-years of follow-up.

During this study, there were 10,371 diagnoses of cancer, of which 16% were AIDS-related and 84% non-AIDS related.
The incidence of all three AIDS-defining cancers was significantly higher among people with HIV compared to the general population (Kaposi's sarcoma, SIR = 103,34, non-Hodgkin's lymphoma, SIR = 3,05, cervical cancer, SIR = 2,02).

Rates of various cancers related to HIV cancers were also high among people with HIV, including cancer of the anus (SIR = 14), liver (SIR = 2,91), lung (SIR = 1,71) and mouth / throat (SIR = 1,66). In contrast, people with HIV had a relative reduction in risk of breast cancer (SIR = 0,61), prostate (SIR = 0,47), and colon (SIR = 0,63).

1It appeared that the risks for almost all types of cancer were higher for younger people and their incidence decreased with age. If aging led to a higher risk of cancer in people with HIV compared to the general population, the reverse should be true. The absolute risk for the three cancers that define AIDS, Kaposi's sarcoma, cervical cancer and Hodgkin's lymphoma. In addition, the risk gradually decreased with advancing age (!!!) with age. However, the absolute risk increased with age for cancer of the anus, lung, liver and mouth / throat.

A previous diagnosis of AIDS was associated with an increased risk of the two major AIDS-defining cancers, Kaposi's sarcoma, non-Hodgkin's lymphoma and Hodgkin's lymphoma, as well as anal, oral, lung and throat cancers (AIRRs ranging from 1,37- 2,66).

The highest rates of cancers were highest within the first five years after HIV diagnosis and then declined gradually over time.

A significant reduction of trends was observed for Kaposi's sarcoma (p <0,0001), non-lymphoma lymphoma (p <0,0001), lung cancer (p = 0,0002), breast cancer (p = 0,02), and Hodgkin's lymphoma (p = 0,04).

In contrast, there is some indication of risk increasing over time from the diagnosis of HIV to liver cancer, although the trends were of borderline significance.

"There is a need for continued prevention of cancer prevention and early detection of it among older PLHAs," the researchers conclude. "Cancer risk was highest within the first 5 years after HIV diagnosis for most cancers, underscoring the importance of early HIV diagnosis, early initiation of ART after HIV diagnosis, and interventions to reduce traditional HIV risk factors. Older PLHA risk. "

Translated by Claudio Souza in 09 February of the original inRisk of some non-AIDS cancers greater for people with HIV than others over 50Written by Michael Carter and Posted: 30 January 2018

Reviewing Mara Macedo