This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Charles S. Rabkin, MD; Margaret W. Hilgartner, MD; Katie W. Hedberg; Louis M. Aledort, MD; Angelos Hatzakis, MD; Sabine Eichinger, MD; M. Elaine Eyster, MD; Gilbert C. White II, MD; Craig M. Kessler, MD; Michael M. Lederman, MD; Philippe de Moerloose, MD; Gordon L. Bray, MD; Alan R. Cohen, MD; W. Abe Andes, MD; Marilyn Manco-Johnson, MD; Wolfgang Schramm, MD; Barbara L. Kroner, MPH; William A. Blattner, MD; James J. Goedert, MD

JAMA. 1992;267(8):1090-1094.

Abstract
Objective.
—To determine the types and rates of cancers occurring in excess in the presence of infection with the human immunodeficiency virus type 1 (HIV-1).

Design.
—Cohort analytic study of HIV-infected and HIV-uninfected subjects followed for up to 12 years.

Setting.
—Fifteen hemophilia treatment centers.

Patients.
—A total of 1701 patients with hemophilia, of whom 1065 (63%) were HIV-1 seropositive.

Main Outcome Measures.
—Morphologic classification and incidence rates of cancers.

Main Results.
—The incidence of non-Hodgkin's lymphoma after HIV seroconversion averaged 0.15 case per 100 person-years (95% confidence interval [CI], 0.08 to 0.25) and rose exponentially with increasing duration of HIV infection. Although the greatest absolute risk of lymphoma was in the oldest age group, the relative increase compared with general population rates was 38-fold in subjects 10 to 39 years old and 12-fold in older subjects (P<.05). The CD4⁺ T-lymphocyte levels for lymphoma cases were similar to HIV-positive subjects without the acquired immunodeficiency syndrome (AIDS) who had been infected for the same length of time. The incidence of Kaposi's sarcoma was increased 200-fold (95% CI, 20 to 700). The incidence of cancers other than non-Hodgkin's lymphoma and Kaposi's sarcoma were not increased in the HIV-positive subjects (ratio of observed to expected cases, 0.9 [95% CI, 0.4 to 1.9]). The HIV-negative subjects had no significant increase in cancer incidence.

Conclusions.
—HIV infection has restricted effects on cancer incidence that are only partly explained by immunosuppression. Paradoxically, improvements in therapy of HIV infection that prolong survival may lead to further increases in HIVassociated lymphoma.

(JAMA. 1992;267:1090-1094)

Footnotes
A complete list of the authors' affiliations appears at the end of this article. Presented in part at the Seventh International Conference on AIDS, Florence, Italy, June 18, 1991.

Reprint requests to Viral Epidemiology Section, National Cancer Institute, 6130 Executive Blvd, EPN/434, Rockville, MD 20852 (Dr Rabkin).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk Factors for Pediatric Human Immunodeficiency Virus-Related Malignancy
Pollock et al.
JAMA 2003;289:2393-2399.
ABSTRACT | FULL TEXT  

Ham-Wasserman Lecture : Hemophilia and Related Bleeding Disorders: A Story of Dismay and Success
Mannucci
ASH Education Book 2002;2002:1-9.
ABSTRACT | FULL TEXT  

The Hemophilias -- From Royal Genes to Gene Therapy
Mannucci and Tuddenham
NEJM 2001;344:1773-1779.
FULL TEXT  

Highly Active Antiretroviral Therapy and Incidence of Cancer in Human Immunodeficiency Virus-Infected Adults
International Collaboration on HIV and Cancer
JNCI J Natl Cancer Inst 2000;92:1823-1830.
ABSTRACT | FULL TEXT  

Epstein-Barr Virus Infection Is Predictive of CNS Involvement in Systemic AIDS-Related Non-Hodgkin's Lymphomas
Cingolani et al.
JCO 2000;18:3325-3330.
ABSTRACT | FULL TEXT  

Chemokine and Chemokine Receptor Gene Variants and Risk of Non-Hodgkin's Lymphoma in Human Immunodeficiency Virus-1-Infected Individuals
Rabkin et al.
Blood 1999;93:1838-1842.
ABSTRACT | FULL TEXT  

Association of Non-Acquired Immunodeficiency Syndrome-Defining Cancers With Human Immunodeficiency Virus Infection
Rabkin
J Natl Cancer Inst Monogr 1998;1998:23-25.
ABSTRACT | FULL TEXT  

Hodgkin's Disease in the Setting of Human Immunodeficiency Virus Infection
Levine
J Natl Cancer Inst Monogr 1998;1998:37-42.
ABSTRACT | FULL TEXT  

CD4+ T-Lymphocyte Measures in the Treatment of Individuals Infected With Human Immunodeficiency Virus Type 1: A Review for Clinical Practitioners
Turner et al.
Arch Intern Med 1994;154:1561-1573.
ABSTRACT  

Increased Incidence of Hodgkin Disease in Homosexual Men with HIV Infection
Hessol et al.
ANN INTERN MED 1992;117:309-311.
ABSTRACT