Abstract
ObjectivesThe current study aimed at describing the distribution and characteristics of malignancy related deaths in human immunodeficiency virus (HIV) infected patients in 2010 and at comparing them to those obtained in 2000 and 2005.MethodsData were obtained from three national surveys conducted in France in 2010, 2005 and 2000. The underlying cause of death was documented using a standardized questionnaire fulfilled in French hospital wards involved in the management of HIV infection.ResultsAmong the 728 deaths reported in 2010, 262 were cancer-related (36%). After a significant increase from 28% in 2000 to 33% in 2005 and 36% in 2010, cancers represent the leading cause of mortality in HIV infected patients. The proportion of deaths attributed to non-AIDS/non-hepatitis-related cancers significantly increased from 2000 to 2010 (11% of the deaths in 2000, 17% in 2005 and 22% in 2010, p<0.001), while those attributed to AIDS-defining cancers decreased during the same period (16% in 2000, 13% in 2005 and 9% in 2010, p = 0.024). Particularly, the proportion of respiratory cancers significantly increased from 5% in 2000 to 6% in 2005 and 11% in 2010 (p = 0.004). Lung cancer was the most common cancer-related cause of death in 2010 (instead of non-Hodgkin lymphoma so far) and represented the leading cause of death in people living with HIV overall.ConclusionsCancer prevention (especially smoking cessation), screening strategies and therapeutic management need to be optimized in HIV-infected patients in order to reduce mortality, particularly in the field of respiratory cancers.
Highlights
The advent of combination antiretroviral therapies has dramatically reduced mortality and incidence of AIDS-defining events in people living with human immunodeficiency virus (HIV) [1]
The proportion of deaths attributed to non-AIDS/ non-hepatitis-related cancers significantly increased from 2000 to 2010 (11% of the deaths in 2000, 17% in 2005 and 22% in 2010, p
GC has had scientific responsibilities in projects receiving specific grant supports that are managed through her Institution or a non-profit society: from the French Agency for Research on AIDS and Viral Hepatitis (ANRS), the European Commission (Framework Program 7), U.K
Summary
The advent of combination antiretroviral therapies (cART) has dramatically reduced mortality and incidence of AIDS-defining events in people living with HIV [1]. The risk of malignancies, including non-AIDS-related cancers, remains higher in patients living with HIV than in the general population, with a poorer prognosis reported [2,3,4]. Lung cancer is a leading cause of mortality in HIV-infected patients [5] with a worse prognosis than in the general population [6,7,8]. In two previous national prospective surveys designed to assess the underlying cause of death in HIV-infected patients conducted in 2000 and 2005 in France [10,11], we showed that in these two periods of time, malignancies accounted for 28% and 33% of the causes of death in this population, respectively, and the proportion of non-AIDS-related cancers significantly increased from 11% in 2000 to 17% in 2005 [5]
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