Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study.
<h4>Objectives</h4>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.<h4>Methods</h4>Multi-center, retrospective,...
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0094768&type=printable |
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| author | Daria Gotti Elena Raffetti Laura Albini Laura Sighinolfi Franco Maggiolo Elisa Di Filippo Nicoletta Ladisa Gioacchino Angarano Giuseppe Lapadula Angelo Pan Anna Degli Esposti Massimiliano Fabbiani Emanuele Focà Alfredo Scalzini Francesco Donato Eugenia Quiros-Roldan Master Cohort Group |
| author_facet | Daria Gotti Elena Raffetti Laura Albini Laura Sighinolfi Franco Maggiolo Elisa Di Filippo Nicoletta Ladisa Gioacchino Angarano Giuseppe Lapadula Angelo Pan Anna Degli Esposti Massimiliano Fabbiani Emanuele Focà Alfredo Scalzini Francesco Donato Eugenia Quiros-Roldan Master Cohort Group |
| author_sort | Daria Gotti |
| collection | DOAJ |
| description | <h4>Objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| format | Article |
| id | doaj-art-0d4a9d45f05b49a085676d3e41d5126c |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-0d4a9d45f05b49a085676d3e41d5126c2025-08-20T02:14:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9476810.1371/journal.pone.0094768Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study.Daria GottiElena RaffettiLaura AlbiniLaura SighinolfiFranco MaggioloElisa Di FilippoNicoletta LadisaGioacchino AngaranoGiuseppe LapadulaAngelo PanAnna Degli EspostiMassimiliano FabbianiEmanuele FocàAlfredo ScalziniFrancesco DonatoEugenia Quiros-RoldanMaster Cohort Group<h4>Objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0094768&type=printable |
| spellingShingle | Daria Gotti Elena Raffetti Laura Albini Laura Sighinolfi Franco Maggiolo Elisa Di Filippo Nicoletta Ladisa Gioacchino Angarano Giuseppe Lapadula Angelo Pan Anna Degli Esposti Massimiliano Fabbiani Emanuele Focà Alfredo Scalzini Francesco Donato Eugenia Quiros-Roldan Master Cohort Group Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. PLoS ONE |
| title | Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. |
| title_full | Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. |
| title_fullStr | Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. |
| title_full_unstemmed | Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. |
| title_short | Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study. |
| title_sort | survival in hiv infected patients after a cancer diagnosis in the cart era results of an italian multicenter study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0094768&type=printable |
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