A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals

Meredith S. Shiels, Stephen R. Cole, Gregory D Kirk, Charles Poole

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To estimate summary standardized incidence ratios (SIRs) of non-AIDS cancers among HIV-infected individuals compared with general population rates overall and stratified by gender, AIDS, and highly active antiretroviral therapy (HAART) era. DESIGN: A meta-analysis using SIRs from 18 studies of non-AIDS cancer in HIV-infected individuals. METHODS: SIRs for non-AIDS cancers in HIV-infected individuals and 95% confidence limits (CLs) were abstracted from each study. Random effects meta-analyses were used to estimate summary SIRs. Modifications by gender, AIDS, and HAART era were estimated with meta-regression. RESULTS: Four thousand seven hundred ninety-seven non-AIDS cancers occurred among 625,716 HIV-infected individuals. SIRs for several cancers were elevated. In particular, cancers associated with infections, such as anal (SIR = 28; 95% CL 21 to 35), liver (SIR = 5.6; 95% CL 4.0 to 7.7), and Hodgkin lymphoma (SIR = 11; 95% CL 8.8 to 15) and smoking, such as lung (SIR = 2.6; 95% CL 2.1 to 3.1), kidney (SIR = 1.7; 95% CL 1.3 to 2.2), and laryngeal (SIR = 1.5; 95% CL 1.1 to 2.0). AIDS was associated with greater SIRs for Hodgkin lymphoma, leukemia, lung, brain, and all non-AIDS cancers combined. CONCLUSIONS: HIV-infected individuals may be at an increased risk of developing non-AIDS cancers, particularly those associated with infections and smoking. An association with advanced immune suppression was suggested for certain cancers.

Original languageEnglish (US)
Pages (from-to)611-622
Number of pages12
JournalJournal of Acquired Immune Deficiency Syndromes
Volume52
Issue number5
DOIs
StatePublished - Dec 2009

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Meta-Analysis
HIV
Incidence
Neoplasms
Acquired Immunodeficiency Syndrome
Highly Active Antiretroviral Therapy
Hodgkin Disease
Smoking
Lung
Infection
Leukemia
Kidney
Liver
Brain

Keywords

  • AIDS
  • Cancer
  • Epidemiology
  • HIV
  • Meta-analysis

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Medicine(all)

Cite this

A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. / Shiels, Meredith S.; Cole, Stephen R.; Kirk, Gregory D; Poole, Charles.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 52, No. 5, 12.2009, p. 611-622.

Research output: Contribution to journalArticle

Shiels, Meredith S. ; Cole, Stephen R. ; Kirk, Gregory D ; Poole, Charles. / A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. In: Journal of Acquired Immune Deficiency Syndromes. 2009 ; Vol. 52, No. 5. pp. 611-622.
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KW - Epidemiology

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