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Incidence of Non–AIDS-Defining Cancers Before and During the Highly Active Antiretroviral Therapy Era in a Cohort of Human Immunodeficiency Virus–Infected Patients

Magid Herida, Murielle Mary-Krause, Régis Kaphan, Jacques Cadranel, Isabelle Poizot-Martin, Christian Rabaud, Nathalie Plaisance, Hervé Tissot-Dupont, François Boue, Jean-Marie Lang, Dominique Costagliola

From the Institut National de la Santé et de la Recherche Médicale Equipe Mixte 0214 and Hôpital Tenon, Paris; Hôpital Archet 1, Nice; Hôpital Sainte-Marguerite and Hôpital de la Conception, Marseille; Hôpitaux de Brabois, Vandoeuvre; CISIH d’Alsace, Alsace; and Hôpital Antoine Béclère, Clamart, France.

Address reprint requests to Murielle Mary-Krause, PhD, Institut National de la Santé et de la Recherche Médicale Equipe Mixte 0214, 56 Boulevard Vincent Auriol, BP 335, 75625 Paris Cedex 13, France; e-mail: murielle.mary-krause{at}ccde.chups.jussieu.fr.

Purpose: To determine incidence of non–AIDS-defining cancers (NADC) in HIV–infected patients before (P1) and during (P2) the use of highly active antiretroviral therapy (HAART) relative to that observed in the French general population (FGP) of the same age and sex.

Patients and Methods: Sex- and age-adjusted NADC standardized incidence ratios (SIR), with FGP as reference, were estimated in 1992 to 1995 (P1) and in 1996 to 1999 (P2) in a French Hospital Database on HIV prospective hospital cohort study.

Results: NADCs were diagnosed in 260 patients during P1 and 391 patients during P2 among the 77,025 patients included in the database between January 1, 1992, and December 31, 1999. Estimated incidence of all cancers was higher in HIV-infected men than in FGP during both periods (P1 SIR = 2.36 and P2 SIR = 1.91). No excess of cancers was observed among HIV-infected women in either period. Incidence of all cancers did not change from P1 to P2 in either sex (SIR = 0.96 for men and 1.00 for women). In contrast, incidence of Hodgkin’s disease (HD) was higher than in FGP in both sexes and both periods and increased in P2 as compared with P1; incidence of lung cancer was higher in both sexes during P2.

Conclusion: Relative to FGP, the overall incidence of NADCs was increased in HIV-infected men but not in women and did not differ between P1 and P2. Only HD was much more common in HIV infection, and the potential role of HAART on HD cannot be excluded.

Supported by the Institut National de la Santé et de la Recherche Médicale, the Agence Nationale de Recherches sur le SIDA, and the Fondation pour la Recherche Médicale, Paris, France.

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Related Correspondence

• Reasons for a Deficit of Breast Cancer Among HIV-Infected Patients
  Liron Pantanowitz and Bruce J. Dezube
  JCO 2004 22: 1347-1348 [Full Text]
• HIV and the Risk of Lung Cancer
  Thomas Powles and Mark Bower
  JCO 2004 22: 1348-1349 [Full Text]

Related Reply

• In Reply:
  Murielle Mary-Krause, Magid Herida, Dominique Costagliola, Armelle Lavolé, and Jacques Cadranel
  JCO 2004 22: 1349-1350 [Full Text]

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