Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study

Br J Cancer. 2010 Jul 27;103(3):416-22. doi: 10.1038/sj.bjc.6605756. Epub 2010 Jun 29.

Abstract

Background: The advent of highly active antiretroviral therapy (HAART) in 1996 led to a decrease in the incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), but not of other cancers, among people with HIV or AIDS (PWHA). It also led to marked increases in their life expectancy.

Methods: We conducted a record-linkage study between the Swiss HIV Cohort Study and nine Swiss cantonal cancer registries. In total, 9429 PWHA provided 20,615, 17,690, and 15,410 person-years in the pre-, early-, and late-HAART periods, respectively. Standardised incidence ratios in PWHA vs the general population, as well as age-standardised, and age-specific incidence rates were computed for different periods.

Results: Incidence of KS and NHL decreased by several fold between the pre- and early-HAART periods, and additionally declined from the early- to the late-HAART period. Incidence of cancers of the anus, liver, non-melanomatous skin, and Hodgkin's lymphoma increased in the early- compared with the pre-HAART period, but not during the late-HAART period. The incidence of all non-AIDS-defining cancers (NADCs) combined was similar in all periods, and approximately double that in the general population.

Conclusions: Increases in the incidence of selected NADCs after the introduction of HAART were largely accounted for by the ageing of PWHA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • Chromosome Mapping
  • Cohort Studies
  • Drug Administration Schedule
  • Female
  • HIV Infections / drug therapy
  • Humans
  • Incidence
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Sarcoma, Kaposi / epidemiology
  • Skin Neoplasms / epidemiology
  • Switzerland / epidemiology