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Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study

D'Souza, G and Wiley, DJ and Li, X and Chmiel, JS and Margolick, JB and Cranston, RD and Jacobson, LP (2008) Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. Journal of Acquired Immune Deficiency Syndromes, 48 (4). 491 - 499. ISSN 1525-4135

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Abstract

OBJECTIVE:: To examine the incidence and risk factors for anal cancer in a multicenter cohort of human immunodeficiency virus (HIV) positive and HIV-negative men who have sex with men followed between 1984 and 2006 (Multicenter AIDS Cohort Study). METHODS:: Prospective analysis using Poisson regression and Cox proportional hazard models and a nested case-control study using conditional logistic regression. RESULTS:: There were 28 cases of anal cancer among the 6972 men who were evaluated. The incidence rate was significantly higher in HIV-positive men than in HIV-negative men (incidence rate = 69 vs 14 per 100,000 person-years). Among HIV-positive men, anal cancer incidence was higher in the highly active antiretroviral therapy (HAART) era than the pre-HAART era (incidence rate = 137 vs 30 per 100,000 person-years). In multivariate analysis restricted to the HAART era, anal cancer risk increased significantly with HIV infection (relative hazard = 4.7, 95% confidence interval = 1.3 to 17) and increasing number of unprotected receptive anal sex partners at the first 3 study visits (P trend = 0.03). Among HIV-positive men, current HAART use did not decrease anal cancer risk. CONCLUSIONS:: HIV-positive men had increased risk of anal cancer. Improved survival of HIV-positive individuals after HAART initiation may allow for sufficient time for human papillomavirus-associated anal dysplasias to develop into malignancies, thus explaining the increased incidence of anal cancer in the HAART era. © 2008 by Lippincott Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
D'Souza, G
Wiley, DJ
Li, X
Chmiel, JS
Margolick, JB
Cranston, RDrdc27@pitt.eduRDC27
Jacobson, LP
Centers: Other Centers, Institutes, Offices, or Units > Center for LGBT Health Research
Date: 1 August 2008
Date Type: Publication
Journal or Publication Title: Journal of Acquired Immune Deficiency Syndromes
Volume: 48
Number: 4
Page Range: 491 - 499
DOI or Unique Handle: 10.1097/qai.0b013e31817aebfe
Schools and Programs: School of Medicine > Infectious Diseases and Microbiology
Refereed: Yes
ISSN: 1525-4135
MeSH Headings: Adult; Anti-HIV Agents--therapeutic use; Antiretroviral Therapy, Highly Active; Anus Neoplasms--complications; Anus Neoplasms--epidemiology; Carcinoma, Squamous Cell--complications; Carcinoma, Squamous Cell--epidemiology; Cohort Studies; Disease Progression; HIV; HIV Infections--complications; HIV Infections--drug therapy; Homosexuality, Male; Humans; Incidence; Male; Middle Aged; Proportional Hazards Models; Regression Analysis; Risk Factors; Unsafe Sex
PubMed ID: 18614927
Date Deposited: 15 Jul 2013 19:57
Last Modified: 02 Feb 2019 13:55
URI: http://d-scholarship.pitt.edu/id/eprint/19244

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