Cancer, immunodeficiency and antiretroviral treatment: results from the Australian HIV Observational Database (AHOD)

HIV Med. 2013 Feb;14(2):77-84. doi: 10.1111/j.1468-1293.2012.01038.x. Epub 2012 Aug 30.


Objectives: The objective of the study was to conduct a within-cohort assessment of risk factors for incident AIDS-defining cancers (ADCs) and non-ADCs (NADCs) within the Australian HIV Observational Database (AHOD).

Methods: A total of 2181 AHOD registrants were linked to the National AIDS Registry/National HIV Database (NAR/NHD) and the Australian Cancer Registry to identify those with a notified cancer diagnosis. Included in the current analyses were cancers diagnosed after HIV infection. Risk factors for cancers were also assessed using logistic regression methods.

Results: One hundred and thirty-nine cancer cases were diagnosed after HIV infection among 129 patients. More than half the diagnoses (n = 68; 60%) were ADCs, of which 69% were Kaposi's sarcoma and 31% non-Hodgkin's lymphoma. Among the NADCs, the most common cancers were melanoma (n = 10), lung cancer (n = 6), Hodgkin's lymphoma (n = 5) and anal cancer (n = 5). Over a total of 21021 person-years (PY) of follow-up since HIV diagnosis, the overall crude cancer incidence rate for any cancer was 5.09/1000 PY. The overall rate of cancers decreased from 15.9/1000 PY [95% confidence interval (CI) 9.25-25.40/1000 PY] for CD4 counts < 100 cells/μL to 2.4/1000 PY (95% CI 1.62-3.39/1000 PY) for CD4 counts > 350 cells/μL. Lower CD4 cell count and prior AIDS diagnoses were significant predictors for both ADCs and NADCs.

Conclusions: ADCs remain the predominant cancers in this population, although NADC rates have increased in the more recent time period. Immune deficiency is a risk factor for both ADCs and NADCs.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / epidemiology*
  • Acquired Immunodeficiency Syndrome / immunology
  • Adult
  • Aging
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Anus Neoplasms / epidemiology*
  • Anus Neoplasms / immunology
  • Australia / epidemiology
  • CD4 Lymphocyte Count
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Hodgkin Disease / epidemiology*
  • Hodgkin Disease / immunology
  • Humans
  • Logistic Models
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / immunology
  • Lymphoma, AIDS-Related / drug therapy
  • Lymphoma, AIDS-Related / epidemiology*
  • Lymphoma, AIDS-Related / immunology
  • Male
  • Melanoma / epidemiology*
  • Melanoma / immunology
  • Middle Aged
  • Prospective Studies
  • Risk Factors


  • Anti-HIV Agents