TY - JOUR
T1 - Survival in HIV-infected patients after a cancer diagnosis in the cART era: Results of an Italian multicenter study
AU - Gotti, Daria
AU - Raffetti, Elena
AU - Albini, Laura
AU - Sighinolfi, Laura
AU - Maggiolo, Franco
AU - Di Filippo, Elisa
AU - Ladisa, Nicoletta
AU - Angarano, Gioacchino
AU - Lapadula, Giuseppe
AU - Pan, Angelo
AU - Esposti, Anna Degli
AU - Fabbiani, Massimiliano
AU - Focà, Emanuele
AU - Scalzini, Alfredo
AU - Donato, Francesco
AU - Donato, Federica
AU - Quiros-Roldan, Eugenia
AU - Castelli, F.
AU - Torti, C.
AU - Torti, Carlo
AU - Casari, S.
AU - Nasta, P.
AU - Castelnuovo, F.
AU - El Hamad, I.
AU - Saracino, Annalisa L.
AU - Monno, L.
AU - Cauda, Roberto
AU - Di Giambenedetto, Simona
AU - Colafigli, Manuela
AU - Mazzotta, F.
AU - Lo Caputo, S.
AU - Pierotti, P.
AU - Di Pietro, M.
AU - Di Pietro, Maria Luisa
AU - Ble, C.
AU - Carnevale, G.
AU - Gori, A.
AU - Costarelli, S.
PY - 2014
Y1 - 2014
N2 - Objectives: We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC) or non-AIDS-defining cancer (NADC) diagnosis in the modern cART era. Methods: Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model. Results: Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51%) were ADCs and 431 (49%) were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017). Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001). Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14%) than lung cancer (1-year survival: 28%±8.7%), liver cancer (5-year survival: 31.9%±6.4%) or Hodgkin lymphoma (10-year survival: 24.8%±11.2%). Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs. Conclusions: cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group. © 2014 Gotti et al.
AB - Objectives: We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC) or non-AIDS-defining cancer (NADC) diagnosis in the modern cART era. Methods: Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model. Results: Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51%) were ADCs and 431 (49%) were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017). Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001). Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14%) than lung cancer (1-year survival: 28%±8.7%), liver cancer (5-year survival: 31.9%±6.4%) or Hodgkin lymphoma (10-year survival: 24.8%±11.2%). Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs. Conclusions: cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group. © 2014 Gotti et al.
KW - HIV Infections
KW - Humans
KW - Kaplan-Meier Estimate
KW - Neoplasms
KW - Prognosis
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - HIV Infections
KW - Humans
KW - Kaplan-Meier Estimate
KW - Neoplasms
KW - Prognosis
KW - Proportional Hazards Models
KW - Retrospective Studies
UR - http://hdl.handle.net/10807/193900
U2 - 10.1371/journal.pone.0094768
DO - 10.1371/journal.pone.0094768
M3 - Article
SN - 1932-6203
VL - 9
SP - e94768-e94768
JO - PLoS One
JF - PLoS One
ER -