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To the Editor: Dr Biggar and colleagues¹ recently reported elevated risks of cancer in children with AIDS (acquired immunodeficiency syndrome). As contributors of data to this study, we have several concerns about the authors' conclusions.

First, the authors did not measure the effect of perinatal antiretroviral therapy exposure on the relationship between HIV (human immunodeficiency virus) infection and cancer. However, some AIDS registries contain data on perinatal antiretroviral exposure. Evaluation of these data would help confirm that cancer incidence is not related to antiretroviral exposure.

Second, Biggar et al overestimate the relative risks, which were calculated using the observed and expected number of cancer cases. In a significant departure from previous analyses of matched AIDS and cancer data,^2-5 the study's observed cancer cases were derived from patients with cancers recorded in the cancer registry that matched an AIDS case or cancer cases that appeared in only the AIDS registry. For . . . [Full Text of this Article]

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