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Lung cancer incidence and survival among HIV-infected and uninfected women and men
- Source :
- AIDS (London, England), vol 29, iss 10
- Publication Year :
- 2015
- Publisher :
- eScholarship, University of California, 2015.
-
Abstract
- ObjectivesTo determine the lung cancer incidence and survival time among HIV-infected and uninfected women and men.DesignTwo longitudinal studies of HIV infection in the United States.MethodsData from 2549 women in the Women's Interagency HIV Study (WIHS) and 4274 men in the Multicenter AIDS Cohort Study (MACS), all with a history of cigarette smoking, were analyzed. Lung cancer incidence rates and incidence rate ratios were calculated using Poisson regression analyses. Survival time was assessed using Kaplan-Meier and Cox proportional-hazard analyses.ResultsThirty-seven women and 23 men developed lung cancer (46 HIV-infected and 14 HIV-uninfected) during study follow-up. In multivariable analyses, the factors that were found to be independently associated with a higher lung cancer incidence rate ratios were older age, less education, 10 or more pack-years of smoking, and a prior diagnosis of AIDS pneumonia (vs. HIV-uninfected women). In an adjusted Cox model that allowed different hazard functions for each cohort, a history of injection drug use was associated with shorter survival, and a lung cancer diagnosis after 2001 was associated with longer survival. In an adjusted Cox model restricted to HIV-infected participants, nadir CD4 lymphocyte cell count less than 200 was associated with shorter survival time.ConclusionsOur data suggest that pulmonary damage and inflammation associated with HIV infection may be causative for the increased risk of lung cancer. Encouraging and assisting younger HIV-infected smokers to quit and to sustain cessation of smoking is imperative to reduce the lung cancer burden in this population.
- Subjects :
- Oncology
Male
Lung Neoplasms
HIV Infections
Medical and Health Sciences
Cohort Studies
Substance Misuse
Epidemiology
Immunology and Allergy
2.2 Factors relating to the physical environment
Longitudinal Studies
Aetiology
Lung
Cancer
Incidence (epidemiology)
Incidence
Smoking
Lung Cancer
respiratory system
Middle Aged
Biological Sciences
AIDS
Infectious Diseases
Respiratory
HIV/AIDS
Female
Infection
Cohort study
Adult
medicine.medical_specialty
Immunology
Risk Assessment
survival
Article
Acquired immunodeficiency syndrome (AIDS)
Clinical Research
Internal medicine
Virology
Tobacco
medicine
Humans
Lung cancer
Survival analysis
Tobacco Smoke and Health
business.industry
Prevention
Psychology and Cognitive Sciences
Case-control study
medicine.disease
HIV infection
Survival Analysis
United States
Pneumonia
Good Health and Well Being
business
2.4 Surveillance and distribution
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- AIDS (London, England), vol 29, iss 10
- Accession number :
- edsair.doi.dedup.....f9fd4bfb3ad7377044642184f52005ca