This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chiao, E. Y. Articles by El-Serag, H. B. Search for Related Content PubMed PubMed Citation Articles by Chiao, E. Y. Articles by El-Serag, H. B. Social Bookmarking                            What's this?

Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Elizabeth Y. Chiao, Thomas P. Giordano, Peter Richardson, Hashem B. El-Serag

From the Department of Medicine, Baylor College of Medicine; and the Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX

Corresponding author: Elizabeth Y. Chiao, MD, MPH, Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center (152), 2002 Holcombe Blvd, Houston, TX 77030; e-mail: echiao{at}bcm.edu

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases.

Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans.

Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival.

Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

Supported by Grant No. K23CA124318 from the National Cancer Institute, National Institutes of Health (E.Y.C.) and Grant No. K23MH67505 from the National Institute of Mental Health, National Institutes of Health (T.P.G.).

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J.-P. Spano, D. Costagliola, C. Katlama, N. Mounier, E. Oksenhendler, and D. Khayat AIDS-Related Malignancies: State of the Art and Therapeutic Challenges J. Clin. Oncol., October 10, 2008; 26(29): 4834 - 4842. [Abstract] [Full Text] [PDF]

				C. Oehler-Janne, F. Huguet, S. Provencher, B. Seifert, L. Negretti, M.-O. Riener, M. Bonet, A. S. Allal, and I. F. Ciernik HIV-Specific Differences in Outcome of Squamous Cell Carcinoma of the Anal Canal: A Multicentric Cohort Study of HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy J. Clin. Oncol., May 20, 2008; 26(15): 2550 - 2557. [Abstract] [Full Text] [PDF]