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Immediate Start of ART for HIV May Impact 10-Year Risk for Cancer

Deferral of antiretroviral therapy may lead to small increase in risk for AIDS-defining cancer

doctor with a patient handing him a bottle with pills

TUESDAY, March 16, 2021 (HealthDay News) -- For people with HIV, deferral of antiretroviral therapy (ART) has a small effect on increasing the 10-year risk for cancer, according to a study published online March 16 in the Annals of Internal Medicine.

Frédérique Chammartin, Ph.D., from the University of Basel in Switzerland, and colleagues 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 persons. The 10-year risks for non-AIDS-defining and AIDS-defining cancer were compared for immediate versus deferred ART initiation strategies.

The researchers identified 231 cases of non-AIDS-defining cancer and 272 cases of AIDS-defining cancer during 64,021 person-years of follow-up among HIV-positive persons (median age, 36 years). With immediate ART, the 10-year risks for non-AIDS-defining and AIDS-defining cancer were 2.97 and 2.50 percent, 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 percent confidence interval, −0.01 to 0.26) and 0.29 (95 percent confidence interval, −0.03 to 0.73) percentage points, respectively, for non-AIDS-defining cancer and 0.32 (95 percent confidence interval, 0.21 to 0.44) and 1.00 (95 percent confidence interval, 0.67 to 1.44) percentage points, respectively, for AIDS-defining cancer compared with immediate ART initiation.

"We observed that strategies promoting deferral of ART initiation in ART-naive, HIV-positive persons are associated with a small increase in risk for AIDS-defining cancer," the authors write.

Several pharmaceutical companies provided funding for the study.

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