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Inicio Enfermedades Infecciosas y Microbiología Clínica (English Edition) Risk of cancer in HIV-infected patients in Spain, 2004–2015. The CoRIS cohort ...
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DOI: 10.1016/j.eimce.2019.04.010
Available online 17 May 2019
Risk of cancer in HIV-infected patients in Spain, 2004–2015. The CoRIS cohort study
Riesgo de cáncer en personas con VIH en España, 2004-2015. Estudio de la cohorte CoRIS
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Javier García-Abellána,
Corresponding author
javiergarciaabellan@hotmail.com

Corresponding author.
, Lorena del Ríob, José A. Garcíac, Sergio Padillaa, María Jesús Vivancosd, Jorge del Romeroe, Víctor Asensif, Asunción Hernandog, Lucio García-Fraileh, Mar Masiáa, Félix Gutiérreza, The Cohort of the National AIDS Network (CoRIS) 1
a Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario de Elche y Universidad Miguel Hernández, Alicante, Spain
b Servicio de Oncología Médica, Hospital General Universitario de San Juan de Alicante y Universidad Miguel Hernández, Alicante, Spain
c Instituto de Investigación Operativa, Universidad Miguel Hernández, Alicante, Spain
d Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain
e Centro Sanitario Sandoval, Madrid, Spain
f Servicio de Enfermedades Infecciosas, Hospital Central de Asturias, Oviedo, Spain
g Instituto de Investigación, Hospital Universitario Doce de Octubre, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
h Servicio de Enfermedades Infecciosas, Hospital Universitario La Princesa, Madrid, Spain
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Table 1. General characteristics of patients included in the CoRIS cohort between 2004 and 2015 (n=12,239).
Table 2. Incidence of AIDS-defining cancers and non-AIDS-defining cancers in CoRIS in 2004–2009 and 2010–2015.
Table 3. Incidence rates of malignancies in HIV-infected patients included in CoRIS and in the general population in Spain during 2010–2015.
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Abstract
Introduction

Cancer is a leading cause of death in individuals with HIV.

Methods

The incidence of cancer in HIV patients of the CoRIS cohort in the 2004–2009 and 2010–2015 periods has been analysed and compared to the incidence in the Spanish general population, estimated from data of the Spanish Cancer Registry Network.

Results

Between January 2004 and November 2015, 12,239 patients were included in CoRIS and 338 incident cancer cases were diagnosed. The overall incidence of cancer per 100,000 persons-year (95% CI) was 702.39 (629.51–781.42) with no significant differences between the 2 periods. A 38% of the incident cancer cases were AIDS defining cancers (ADC) and 62% non-AIDS defining cancers (NADC). In the period 2010–2015, there was a significant decrease in the incidence of ADC (standardised incidence ratio [SIR]); 95% CI: 0.38; 0.21–0.66) and NADC predominated. Compared to the general population, the incidence of cancer was double in men with HIV. Higher relative risks were documented (SIR; 95% CI) for Hodgkin's lymphoma in both sexes (males: 8.37, 5.13–14.17; females: 21.83, 2.66–47.79), non-Hodgkin's lymphoma in males (5.30, 2.86–8.45) and cervical cancer (7.43, 3.15–13.87) and head and neck cancer (3.28, 1.21–5.82) in women.

Conclusions

The overall incidence of cancer in individuals with HIV is higher than in the Spanish general population, and it has remained stable since 2004 with a current predominance of NADC. These data suggest that additional efforts should be made in the prevention and the early detection of cancer in these patients.

Keywords:
HIV
Cancer
Tumour
Malignant neoplasm
Mortality
Comorbidities
Non-AIDS event
Resumen
Introducción

El cáncer constituye una causa importante de mortalidad en personas con VIH.

Métodos

Se ha analizado la incidencia de cáncer en pacientes con VIH de CoRIS en los períodos 2004-2009 y 2010-2015 y se ha comparado con la de la población general española estimada a partir de los datos de la Red Española de Registros de Cáncer.

Resultados

Entre enero de 2004 y noviembre de 2015 se incluyeron en CoRIS 12.239 pacientes y se diagnosticaron 338 casos incidentes de cáncer. La incidencia global por cada 100.000 personas/año (IC 95%) fue de 702,39 (629,51-781,42) sin diferencias significativas entre los 2 períodos. El 38% de las neoplasias fueron tumores definitorios de sida (TDS) y el 62% no definitorios de sida (TNDS). En el período 2010-2015 se observó un descenso significativo en la incidencia de TDS (cociente de tasas de incidencia estandarizadas [SIR]; IC 95%: 0,38; 0,21-0,66) y predominaron los TNDS. En comparación con la población general, la incidencia de cáncer fue el doble en varones con VIH. Se documentaron riesgos relativos (SIR; IC 95%) más altos de linfoma Hodgkin en ambos sexos (varones: 8,37; 5,13-14,17; mujeres: 21,83; 2,66-47,79), linfoma no Hodgkin en varones (5,30; 2,86-8,45) y cáncer de cérvix (7,43; 3,15-13,87) y cabeza y cuello (3,28; 1,21-5,82) en mujeres.

Conclusiones

La incidencia global de cáncer en personas con VIH es mayor que en la población general española y se mantiene estable desde 2004, con un predominio actual de los TNDS. Estos datos indican que deben realizarse esfuerzos adicionales en la prevención y detección precoz de cáncer en estos pacientes.

Palabras clave:
VIH
Cáncer
Tumor
Neoplasia maligna
Mortalidad
Comorbilidades
Evento no sida

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