Ten-year survival among HIV-1 infected subjects with AIDS- or non-AIDS-defining malignancies
Menée en Italie, cette étude observationnelle rétrospective évalue la survie à 10 ans de patients atteints de cancer et infectés par le VIH
Abstract Few data are available regarding the ten-year survival among subjects with HIV and cancer. The aim of this study was to evaluate the ten-year survival of HIV-infected subjects with AIDS-defining malignancies (ADM) or non-AIDS-defining malignancies (NADM). This was a single centre, retrospective, observational study of subjects with HIV infection and a subsequent cancer diagnosis; the data were collected from January 1991 to April 2010. Malignancies were divided into ADM or NADM on the basis of the CDC-1993 classification. Survival curves were estimated using Kaplan-Meyer method and compared by the log-rank test. Six hundred and fifteen (9.5%) of the 6495 subjects recorded in the San Raffaele Infectious Diseases Database developed a malignancy: 431 (70%) an ADM and 184 (30%) a NADM. In the case of ADM, survival was more favourable when cancer was diagnosed during post-HAART era (10-year survival: 43.2±4.4%) than when diagnosed during the pre-HAART era (10-year survival: 16.4±2.7%; log-rank test: p<0.001). The same was true in the case of NADM (10-year survival: 44.7±5.5% vs 33.3±9.6%; log-rank test: p=0.03). An evaluation of survival probability by cancer type showed higher survival rates during the post-HAART era in the case of non-Hodgkin lymphoma (10-year survival: 42.1±5.3% vs 11.4±3.3%; log-rank test: p=<0.001), Kaposi's sarcoma (10-year survival: 44.0±8.4% vs 23.5±3.9%; log-rank test: p<0.001) and Hodgkin's disease (10-year survival: 49.5±14.5% vs 40.0±12.7%; log-rank test: p=0.005). Despite the better cancer prognosis during the post-HAART era, the ten-year survival of HIV-infected subjects with an ADM or NADM is poor.