For people with HIV, deferral of ART has a small effect on increasing the 10-year risk for cancer, according to a study published in the Annals of Internal Medicine. Investigators estimated the long-term risk difference for cancer with an immediate ART strategy in the Data Collection on Adverse Events of Anti-HIV Drugs study. Data were included for 8,318 HIV-positive people. The 10-year risks for non-AIDS-defining and AIDS-defining cancer were compared for immediate versus deferred ART initiation strategies. The study team identified 231 cases of non-AIDSdefining cancer and 272 cases of AIDSdefining cancer during 64,021 person-years of follow-up among HIV-positive persons (median age, 36). With immediate ART, the 10-year risks for non-AIDS-defining and AIDS-defining cancer were 2.97% and 2.50%, respectively. When deferring ART to CD4 counts less than 500 x 109 cells/L and less than 350 x 109 cells/L, the 10-year absolute risk differences were 0.12 (95% confidence interval [CI], −0.01 to 0.26) and 0.29 (95% CI, −0.03 to 0.73) percentage points, respectively, for non-AIDS-defining cancer and 0.32 (95% CI, 0.21 to 0.44) and 1.00 (95% CI, 0.67 to 1.44) percentage points, respectively, for AIDS-defining cancer compared with immediate ART initiation.
