10th Anniversary Conference Of The British HIV Association [BHIVA] 15 – 17 April 2004, City Hall, Cardiff, UK

[AUTHOR(S):] C Thirlwell, T Powles, T Newsom-Davis, A Waterston, S Mandalia, MR Nelson, BG Gazzard, M Bower
Chelsea and Westminster Hospital, London, UK

BHIVA Conf 2004 Apr 15-17;10:O29

BACKGROUND: The incidence of invasive anal carcinoma is increased among people with HIV. HAART has reduced the incidence of both Kaposi’s sarcoma and non-Hodgkin’s lymphoma, but the effects on anal cancer are unknown.

METHODS: The anal cancer incidence in our prospective cohort of 8640 HIV-seropositive individuals (40,126 patient-years of follow-up) was measured in pre- (1984–1995) and post- (1996–2003) HAART eras and compared to the age- and sex-matched general population of southeast England for 1995 (3.1 ×10⁶) collected by the Thames Cancer Registry.

RESULTS: The incidence of anal cancer (diagnosed in 26 patients) in our HIV+ cohort was 60/105 patient-years. This is 120 times higher than in the matched population. The incidence was 35 [95% confidence interval (CI) 15–72]/105 patient-years in the pre-HAART era and 92 (95% CI 52–149)/105 patient-years in the post-HAART era. These figures are significantly higher than in the matched population (P<0.001 for both), and give relative risks of 67 and 176, respectively.

CONCLUSIONS: HAART has not reduced the incidence of anal cancer. Among possible explanations for this is the lack of clear correlation between anal cancer and the CD4 cell count and the fact that HAART does not cause regression of anal intraepithelial neoplasia, the presumed precursor of anal cancer.

PRESENTING AUTHOR: C Thirlwell

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Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD