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Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study

Franceschi, S.
Lise, M.
Clifford, G. M.
Rickenbach, M.
Levi, F.
Maspoli, M.
Dehler, S.
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Published in British journal of cancer. 2010, vol. 103, no. 3, p. 416-422
Abstract BACKGROUND: The advent of highly active antiretroviral therapy (HAART) in 1996 led to a decrease in the incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), but not of other cancers, among people with HIV or AIDS (PWHA). It also led to marked increases in their life expectancy. METHODS: We conducted a record-linkage study between the Swiss HIV Cohort Study and nine Swiss cantonal cancer registries. In total, 9429 PWHA provided 20,615, 17,690, and 15,410 person-years in the pre-, early-, and late-HAART periods, respectively. Standardised incidence ratios in PWHA vs the general population, as well as age-standardised, and age-specific incidence rates were computed for different periods. RESULTS: Incidence of KS and NHL decreased by several fold between the pre- and early-HAART periods, and additionally declined from the early- to the late-HAART period. Incidence of cancers of the anus, liver, non-melanomatous skin, and Hodgkin's lymphoma increased in the early- compared with the pre-HAART period, but not during the late-HAART period. The incidence of all non-AIDS-defining cancers (NADCs) combined was similar in all periods, and approximately double that in the general population. CONCLUSIONS: Increases in the incidence of selected NADCs after the introduction of HAART were largely accounted for by the ageing of PWHA.
Keywords Acquired Immunodeficiency Syndrome/drug therapyAdultAgedAntiretroviral Therapy, Highly Active/*adverse effectsChromosome MappingCohort StudiesDrug Administration ScheduleFemaleHIV Infections/drug therapyHumansIncidenceLymphoma, Non-Hodgkin/*epidemiologyMaleMiddle AgedNeoplasms/*epidemiologySarcoma, Kaposi/epidemiologySkin Neoplasms/epidemiologySwitzerland/epidemiology
PMID: 20588274
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Research group Unité HIV (46)
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FRANCESCHI, S. et al. Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study. In: British journal of cancer, 2010, vol. 103, n° 3, p. 416-422. doi: 10.1038/sj.bjc.6605756 https://archive-ouverte.unige.ch/unige:20946

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Deposited on : 2012-05-23

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