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Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: Implications for HAART use and NADM development.

Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: Implications for HAART use and NADM development.
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Chiu CG, Smith D, Salters KA, Zhang W, Kanters S, Milan D, Montaner JSG, Coldman A, Hogg RS, Wiseman SM,


Chiu CG, Smith D, Salters KA, Zhang W, Kanters S, Milan D, Montaner JSG, Coldman A, Hogg RS, Wiseman SM, (click to view)

Chiu CG, Smith D, Salters KA, Zhang W, Kanters S, Milan D, Montaner JSG, Coldman A, Hogg RS, Wiseman SM,

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BMC cancer 2017 04 1417(1) 270 doi 10.1186/s12885-017-3229-1

Abstract
BACKGROUND
The objective of this study is to evaluate the incidence of non-AIDS defining malignancies (NADMs) among people living with HIV/AIDS (PLWHA) in British Columbia, focusing on clinical correlates, highly active antiretroviral therapy (HAART) use, and survival, in order to elucidate mechanisms for NADM development.

METHODS
A retrospective population based analysis was carried out for individuals with HIV/AIDS that began their treatment between 1996 and 2008.

RESULTS
There were 145 (2.95%) NADMs and 123 (2.50%) AIDS defining malignancies (ADMs) identified in 4918 PLWHA in the study population. NADMs were represented by a range of cancer types including, most commonly, lung cancer, followed by anal, breast, head/neck, prostate, liver, rectal, and renal cancers. PLWHA had a SIR of 2.05 (CI:1.73, 2.41) for the development of NADMs compared to individuals without an HIV/AIDS diagnosis in the general population. Independent factors significantly associated with a NADM were: male gender, older age, lower CD4 cell counts, previous NADM, absence of HAART (non-HAART versus HAART) and treatment during the early-HAART era (before 2000 versus after 2000).

CONCLUSIONS
NADMs represent an important source of morbidity for PLWHA. Use of HAART with its associated improvement in immune-restoration, and tailored targeted cancer screening interventions, may be beneficial and improve outcomes in this unique patient population.

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