Integrase Strand Transfer Inhibitor Use and Cancer Incidence in a Large Cohort Setting

被引：3

作者：

Greenberg, Lauren ^{[1
]}

Ryom, Lene ^{[2
]}

Neesgaard, Bastian ^{[2
]}

Miro, Jose M. ^{[3
]}

Rasmussen, Line Dahlerup ^{[4
]}

Zangerle, Robert ^{[5
]}

Grabmeier-Pfistershammer, Katharina ^{[6
]}

Gunthard, Huldrych F. ^{[7
,8
]}

Kusejko, Katharina ^{[7
,8
]}

Smith, Colette ^{[1
]}

Mussini, Cristina ^{[9
]}

Menozzi, Marianna ^{[10
]}

Wit, Ferdinand ^{[11
]}

Van der Valk, Marc ^{[11
,12
]}

Monforte, Antonella d'Arminio ^{[13
]}

De Wit, Stephane ^{[14
]}

Necsoi, Coca ^{[15
]}

Pelchen-Matthews, Annegret ^{[1
]}

Lundgren, Jens ^{[2
]}

Peters, Lars ^{[2
]}

Castagna, Antonella ^{[16
]}

Muccini, Camilla ^{[16
]}

Vehreschild, Joerg Janne ^{[17
,18
]}

Pradier, Christian ^{[19
,20
]}

Riera, Andreu Bruguera ^{[21
]}

Sonnerborg, Anders ^{[22
]}

Petoumenos, Kathy ^{[23
]}

Garges, Harmony ^{[24
]}

Rogatto, Felipe ^{[25
]}

Dedes, Nikos ^{[26
]}

Bansi-Matharu, Loveleen ^{[1
]}

Mocroft, Amanda ^{[1
,2
]}

机构：

[1] UCL, Ctr Clin Res Epidemiol Modelling & Evaluat, Inst Global Hlth, London, England

[2] Univ Copenhagen, Rigshosp, CHIP, Copenhagen, Denmark

[3] Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

[4] Odense Univ Hosp, Dept Infect Dis, Odense, Denmark

[5] Med Univ Innsbruck, Austrian HIV Cohort Study AHIVCOS, Innsbruch, Austria

[6] Med Univ Vienna, Vienna, Austria

[7] Univ Hosp Zurich, Dept Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[8] Univ Zurich, Inst Med Virol, Zurich, Switzerland

[9] Univ Modena, Modena HIV Cohort, Modena, Italy

[10] Azienda Osped Univ Modena, Modena, Italy

[11] HIV Monitoring Fdn, AIDS Therapy Evaluat Netherlands Cohort ATHENA, Amsterdam, Netherlands

[12] Univ Amsterdam, Amsterdam Infect & Immun Inst, Dept Infect Dis, Amsterdam UMC, Amsterdam, Netherlands

[13] ASST Santi Paolo & Carlo, Italian Cohort Naive Antiretrovirals ICoNA, Milan, Italy

[14] Univ Libre Bruxelles, Infect Dis, CHU St Pierre, St PIerre Univ Hosp, Brussels, Belgium

[15] CHU St Pierre, Ctr Rech Malad Infect Asbl, Brussels, Belgium

[16] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Milan, Italy

[17] Univ Hosp Frankfurt, Med Dept 2, Hematol Oncol, Frankfurt, Germany

[18] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany

[19] Univ Cote Azur, Nice HIV Cohort, Nice, France

[20] Ctr Hosp Univ, Nice, France

[21] Ctr Estudis Epidemiol ITS & VIH Catalunya, PISCIS Cohort Study, Badalona, Spain

[22] Karolinska Univ Hosp, Swedish InfCare HIV Cohort, Stockholm, Sweden

[23] UNSW, Australian HIV Observat Database AHOD, Sydney, NSW, Australia

[24] ViiV Healthcare, Res Triangle Pk, NC USA

[25] Gilead Sci, Foster City, CA USA

[26] European Aids Treatment Grp, Brussels, Belgium

来源：

OPEN FORUM INFECTIOUS DISEASES | 2022年 / 9卷 / 03期

基金：

芬兰科学院;

关键词：

antiretroviral treatment; cancer; cohort; HIV; integrase inhibitors; COMBINATION ANTIRETROVIRAL THERAPY; AIDS-DEFINING MALIGNANCIES; CHANGING PATTERNS; INITIAL TREATMENT; HIV-1; INFECTION; LIFE EXPECTANCY; DOUBLE-BLIND; RISK; RALTEGRAVIR; TRENDS;

D O I：

10.1093/ofid/ofac029

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

In this analysis including 29 340 individuals from RESPOND and 1078 cancer events, the incidence of cancer decreased as cumulative INSTI exposure increased in ART-naive individuals, however there was no association between cancer risk and INSTI exposure in ART-experienced individuals. Background Limited data exist examining the association between incident cancer and cumulative integrase inhibitor (INSTI) exposure. Methods Participants were followed from baseline (latest of local cohort enrollment or January 1, 2012) until the earliest of first cancer, final follow-up, or December 31, 2019. Negative binomial regression was used to assess associations between cancer incidence and time-updated cumulative INSTI exposure, lagged by 6 months. Results Of 29 340 individuals, 74% were male, 24% were antiretroviral treatment (ART)-naive, and median baseline age was 44 years (interquartile range [IQR], 36-51). Overall, 13 950 (48%) individuals started an INSTI during follow-up. During 160 657 person-years of follow-up ([PYFU] median 6.2; IQR, 3.9-7.5), there were 1078 cancers (incidence rate [IR] 6.7/1000 PYFU; 95% confidence interval [CI], 6.3-7.1). The commonest cancers were non-Hodgkin lymphoma (n = 113), lung cancer (112), Kaposi's sarcoma (106), and anal cancer (103). After adjusting for potential confounders, there was no association between cancer risk and INSTI exposure (<= 6 months vs no exposure IR ratio: 1.15 [95% CI, 0.89-1.49], >6-12 months; 0.97 [95% CI, 0.71-1.32], >12-24 months; 0.84 [95% CI, 0.64-1.11], >24-36 months; 1.10 [95% CI, 0.82-1.47], >36 months; 0.90 [95% CI, 0.65-1.26] [P = .60]). In ART-naive participants, cancer incidence decreased with increasing INSTI exposure, mainly driven by a decreasing incidence of acquired immune deficiency syndrome cancers; however, there was no association between INSTI exposure and cancer for those ART-experienced (interaction P < .0001). Conclusions Cancer incidence in each INSTI exposure group was similar, despite relatively wide CIs, providing reassuring early findings that increasing INSTI exposure is unlikely to be associated with an increased cancer risk, although longer follow-up is needed to confirm this finding.

引用

页数：11

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