Revista de SIDA e investigación clínica

Cancer Incidence and Risk Among HIV-infected Individuals in Taiwan: Results From a Follow-up Study Combining Two Nationwide Registries

Abstract

Marcelo Chen#, I-An Jen#, Wei-You Li and Yi-Ming Arthur Chen*

Background: Previous epidemiological studies have reported an increased risk of some cancers in People Living With HIV/AIDS (PLWHA). This study was performed to investigate the epidemiology of cancers in PLWHA in Taiwan.

Methods: Data from Taiwan’s National Health Research Database and the HIV/AIDS registry of Taiwan CDC were matched to identify HIVpositive cases from January 2001 to December 2016 who subsequently were diagnosed with cancer. These cases were then compared to general population controls in a 20 to 1 controls to cases ratio. The Incidence Density (ID) and Standardized Incidence Ratio (SIR) were calculated for each cancer.

Results: A total of 1,960 PLWHA with cancer were identified in this study period. For the AIDS-defining cancers, the highest ID per 100,000 person-years was for non-Hodgkin’s lymphoma in males (ID=216.17) and cervical cancer in females (ID=480.24). The highest SIR was for Kaposi’s sarcoma in males (SIR=252.29, 95%CI=224.49-284.23) and in females (SIR=166.67, 95%CI=53.71-338.94). For the non-AIDS defining cancers, the highest ID per 100,000 person-years was for liver and intrahepatic duct cancer (ID=96.75) in males and bronchus and lung cancer in females (ID=102.55). The highest SIR was for cancer of the anus or anal canal in males (SIR=46.02, 95%CI=36.55-57.2) and in females (SIR=18.75, 95%CI=3.77-54.78). Survival analysis showed that survival was worse in men without HAART and with cancer than in men with HAART and cancer.

Conclusion: PLWHA are at an increased risk of ADCs and NADCs and HAART improves survival. PLWHA should therefore be screened regularly and aggressively for early cancer detection and treatment.