HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

Antonella d'Arminio Monforte; Donald Abrams; Christian Pradier; Rainer Weber; Peter Reiss; Fabrice Bonnet; Ole Kirk; Matthew Law; Stephane De Wit; Nina Friis-Møller; Andrew N Phillips; Caroline A Sabin; Jens Lundgren; Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group

doi:10.1097/QAD.0b013e3283112b77

HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

Antonella d'Arminio Monforte, Donald Abrams, Christian Pradier, Rainer Weber, Peter Reiss, Fabrice Bonnet, Ole Kirk, Matthew Law, Stephane De Wit, Nina Friis-Møller, Andrew N Phillips, Caroline A Sabin, Jens Lundgren, Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group

200 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. DESIGN: Observational cohort study. METHODS: Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. RESULTS: Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n = 110; nADM: n = 188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/microl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/microl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. CONCLUSION: The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations.

Original language	English
Journal	AIDS
Volume	22
Issue number	16
Pages (from-to)	2143-53
Number of pages	10
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0b013e3283112b77
Publication status	Published - 2008

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10.1097/QAD.0b013e3283112b77

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Monforte, A. DA., Abrams, D., Pradier, C., Weber, R., Reiss, P., Bonnet, F., Kirk, O., Law, M., De Wit, S., Friis-Møller, N., Phillips, A. N., Sabin, C. A., Lundgren, J., & Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group (2008). HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS, 22(16), 2143-53. https://doi.org/10.1097/QAD.0b013e3283112b77

Monforte, ADA, Abrams, D, Pradier, C, Weber, R, Reiss, P, Bonnet, F, Kirk, O, Law, M, De Wit, S, Friis-Møller, N, Phillips, AN, Sabin, CA, Lundgren, J & Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group 2008, 'HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies', AIDS, vol. 22, no. 16, pp. 2143-53. https://doi.org/10.1097/QAD.0b013e3283112b77

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title = "HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies",

abstract = "OBJECTIVE: To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. DESIGN: Observational cohort study. METHODS: Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. RESULTS: Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n = 110; nADM: n = 188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/microl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/microl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. CONCLUSION: The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations.",

author = "Monforte, {Antonella d'Arminio} and Donald Abrams and Christian Pradier and Rainer Weber and Peter Reiss and Fabrice Bonnet and Ole Kirk and Matthew Law and {De Wit}, Stephane and Nina Friis-M{\o}ller and Phillips, {Andrew N} and Sabin, {Caroline A} and Jens Lundgren and {Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group}",

year = "2008",

doi = "10.1097/QAD.0b013e3283112b77",

language = "English",

volume = "22",

pages = "2143--53",

journal = "AIDS, Supplement",

issn = "1350-2840",

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TY - JOUR

T1 - HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

AU - Monforte, Antonella d'Arminio

AU - Abrams, Donald

AU - Pradier, Christian

AU - Weber, Rainer

AU - Reiss, Peter

AU - Bonnet, Fabrice

AU - Kirk, Ole

AU - Law, Matthew

AU - De Wit, Stephane

AU - Friis-Møller, Nina

AU - Phillips, Andrew N

AU - Sabin, Caroline A

AU - Lundgren, Jens

AU - Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group

PY - 2008

Y1 - 2008

N2 - OBJECTIVE: To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. DESIGN: Observational cohort study. METHODS: Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. RESULTS: Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n = 110; nADM: n = 188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/microl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/microl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. CONCLUSION: The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations.

AB - OBJECTIVE: To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. DESIGN: Observational cohort study. METHODS: Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. RESULTS: Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n = 110; nADM: n = 188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/microl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/microl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. CONCLUSION: The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations.

U2 - 10.1097/QAD.0b013e3283112b77

DO - 10.1097/QAD.0b013e3283112b77

M3 - Journal article

C2 - 18832878

SN - 1350-2840

VL - 22

SP - 2143

EP - 2153

JO - AIDS, Supplement

JF - AIDS, Supplement

IS - 16

ER -

HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

Abstract

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