[TuAb0305] DRAMATIC INCREASE IN THE INCIDENCE OF ANAL CANCER DESPITE HAART IN THE FRENCH HOSPITAL DATABASE OF HIV

16th International AIDS Conference

Toronto, Canada - August 13 - 18, 2006

DRAMATIC INCREASE IN THE INCIDENCE OF ANAL CANCER DESPITE HAART IN THE FRENCH HOSPITAL DATABASE OF HIV

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. TuAb0305

C. Piketty¹, H. Selinger-Leneman², S. Grabar³, C. Duvivier⁴, M. Bonmarchand⁴, L. Abramowitz⁵, D. Costagliola², M. Mary-Krause²
¹ Hôpital Europeen Georges Pompidou and Univ Paris 5, Department of Immunology, Paris, France, ² INSERM U720 and Univ Pierre et Marie Curie, Paris, France, ³ INSERM U720 and Hôpital Cochin, Paris, France, ⁴ Hôpital Pitié Salpétrière, Paris, France, ⁵ Hôpital Bichat-Claude Bernard, Paris, France

BACKGROUND: Recent studies suggest that HAART exhibited no effect on the incidence of anal HPV infection and anal SIL precursors of anal cancer. There is limited data on the impact of HAART on the incidence of anal cancer among HIV-infected patients.

METHODS: We recorded and validated the cases of anal cancer diagnosed between 1992 and 2003 in the French Database of HIV (FHDH) that included 74446 HIV-infected patients. Incidence rates of anal cancer among 3 different time periods were compared: 1992 – March 1996 (pre-HAART period), April 1996 – 1998 (early HAART period), 1999 – 2003 (recent HAART period).

RESULTS: We identified 92 cases of anal squamous cell carcinoma, 84 in men (90%) and 8 in women. Among men, 74% were men who have sex with men. The median age at diagnosis was 42.4 years (IQR: 36.0 – 49.3); the median CD4 cell count was 247.5 cells/mm³ (IQR: 135 – 420); the median nadir CD4 cell count was 80 cells/mm³ (IQR: 21 – 174) and 39% of the cases had presented an AIDS defining event prior to the anal cancer diagnosis. At diagnosis, 71 patients (77%) were receiving HAART with a median duration of 65 months (IQR: 44 – 77). Changes in the anal cancer incidence are presented in the Table:


		1992 - Mars 1996	Avril 1996 - Decembre 1998	1999 - 2003
Overall Population	Person/Year	104648	102798	204298
	Number of Cases	9	12	69.00
	Incidence per 100000 p/y [C.I. 95%]	8.6 (3.0, 14.2]	11.7 [5.1, 18.3]	33.8 [25.8, 41.7]
	Relative risk	1	1.36 [0.57, 3.22]	3.93 [1.96, 7.87]
MSM	Persons/year	37923	37046	72647
	Number of cases	6	10	44
	Incidence per 100000 p/y [C.I. 95%]	15.8 [3.2, 28.5]	27 [10.3, 43.7]	60.6 [42.7, 78.5]
	Relative risk	1	1.71 [0.62, 4.69]	383 [1.63, 8.98]

[incidence]

The survival probability after the anal cancer diagnosis was 74%+/ – 6% at 3 years.

CONCLUSIONS: Incidence of anal cancer among HIV-infected patients has increased since 1999. Although some ascertainment bias cannot be excluded, the data indicate that HAART exhibited no favorable effect on the incidence of anal cancer and support the urgent need for developing anal cancer screening programs for HIV-infected individuals, whether untreated or under HAART.

Download PDF of this abstract.

2006-08-13
TuAb0305

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.