Association of Cancer With AIDS-Related Immunosuppression in Adults

TLDR

HIV‑associated immunosuppression markedly elevates the risk of AIDS‑defining cancers such as Kaposi sarcoma and non‑Hodgkin lymphoma, with additional excess cancers varying by region and exposure group. Using the updated AIDS‑Cancer Match Registry, the authors examined cancer incidence around AIDS diagnosis in 302,834 adults to distinguish malignancies driven by immunosuppression from those linked to lifestyle risk factors. They linked cancer records to 366,034 persons with HIV/AIDS from 11 U.S.

Abstract

MMUNOSUPPRESSION ASSOCIATEDwith human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) markedly increases the risk of Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL). 1 These malignancies and invasive cervical cancer are the only AIDS-defining cancers in HIV-infected individuals. 2Other specific cancers also occur in excess, but the risk pattern depends on the geographic region and the HIV exposure group studied. 3,4In industrialized parts of the world, a high level of risk has been found for anal cancer 5 and Hodgkin disease, [6][7][8] and marginally significant increases were reported for seminoma, multiple myeloma, and brain cancer. 7,8We used data from the recently updated AIDS-Cancer Match Registry Study to investigate the cancer pattern in the years surrounding the time of AIDS diagnosis among 302834 adult persons with HIV/ AIDS (PWAs) in the United States.Specifically, we aimed at identifying cancers that are likely to be influenced by immunosuppression, distinguishing them from those occurring in excess among PWAs due to lifestyle-related exposures linked to cancer risk independently of immunosuppression. METHODSWe linked cancer data to 366034 PWAs from 11 areas, including the states of Connecticut, Florida, Illinois, Massa-chusetts, New Jersey, and New York, and the metropolitan areas of Atlanta, Los Angeles, San Diego, San Francisco, and Seattle.Commercially available software (AutoMatch versions 3.0 and 4.1; MatchWare Technologies Inc, Burtonsville, Md) was used to implement a probabilistic matching algorithm that