Search

Background: Data on incidence of cytomegalovirus (CMV) seroconversion in HIV-infected (HIV(+)) subjects was sparse.Goal: To determine the incidence of CMV seroconversion in sexually active HIV(+) subjects and sexual factors associated with CMV seroconversion.Study Design: One hundred eighty four persons not infected by CMV at enrollment in a cohort of HIV(+) persons were studied. A case-control study within the cohort was conducted to determine the effect of sexual behavior in the 6 months prior to CMV seroconversion. Thirty seven cases of CMV seroconversion were compared with 136 controls.Results: The overall incidence of CMV seroconversion was 9.18 per 100 person-years (95% confidence interval (CI), 6.67-12.28) and was particularly high among homosexual men. After adjustment for age, socio-professional category, sexual orientation, and casual sex, the risk of CMV seroconversion was higher in subjects who never used condoms than in those who used them systematically (adjusted odds ratio (OR) 3.37;95% CI, 1.05-11.00).Conclusions: In addition to the need to protect their sexual partners from HIV infection, HIV(+) subjects free of CMV infection should use condoms to avoid CMV infection and its complications. [ABSTRACT FROM AUTHOR]

Background: Many people infected by human immunodeficiency virus (HIV) acquire severe cytomegalovirus (CMV) diseases. Factors associated with CMV seropositivity are poorly documented in sexually active HIV-infected men.Goal: To study CMV seroprevalence in HIV-infected men according to sexual behavior before the diagnosis of HIV seropositivity.Study Design: Cross-sectional study. CMV seroprevalence was studied at enrollment in a prospective cohort of homosexual and heterosexual men infected by HIV through sexual contact.Results: In the study population (n = 723), age, sexual preference, previous lifetime history of sexually transmitted diseases, and multiple sexual partners were independently related to CMV seropositivity. Furthermore, routine condom use during the 6 months before diagnosis of HIV seropositivity was significantly related to CMV seropositivity (adjusted odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.1-1.0), occasional condom use being of borderline significance [adjusted OR: 0.5, CI: 0.2-1.3].Conclusions: This study confirms the importance of sexual factors in the acquisition of CMV infection by HIV-infected men and suggests a protective effect of condom use. [ABSTRACT FROM AUTHOR]

High BMI has been repeatedly identified as a risk factor for breast cancer (BC), but also as an adverse prognostic factor in women with early-stage BC. Little is known about its impact on outcome in patients with metastatic BC (MBC). We used the National ESME-MBC cohort, which includes all consecutive patients (pts) newly diagnosed with MBC between Jan 2008 and Dec 2016 in 18 French comprehensive cancer centres. Women with available BMI at the diagnosis of MBC were selected. Four groups were defined according to WHO classification: underweight (BMI < 18.5 kg/m2), normal weight (18.5-24.9), overweight (25.0-29.9) and obese (≥30.0). Multivariate Cox analyses for OS were conducted in the whole population (primary objective). OS and 1st line progression-free survival (PFS) in subtypes (HER2+, Triple negative BC (TNBC) and HR+ HER2-) were secondary objectives. Of 22 463 patients in the ESME cohort, 12 999 women had BMI data available. Med BMI was 24.9 kg/m2 (range 12.1-66.5). Pts characteristics are reported in Table. Obesity was associated with more de novo MBC, while underweight pts had more aggressive features. Median follow-up was 48.6 months. Median OS was 47.4 months (95% CI [46.2-48.5]). By multivariate analysis, age, visceral metastases, time to MBC, number of metastatic sites, tumor subtype and BMI were independent predictors for OS. Underweight (but not overweight or obesity) was associated with a worse prognosis (HR 1.29, 95%CI [1.16-1.44]), and this was true in each tumour subtype. Median 1st line PFS was 12.2 months, with similar multivariate results. Table 367P Table Underweight Normal weight Overweight Obese p N 637 (5%) 6020 (46%) 3708 (29%) 2634 (20%) Age at MBC diagnosis (med) 58 58 61 60 <0.001 De novo MBC 228 (36%) 1939 (32%) 1389 (37%) 1132 (43%) 0.000 Time to MBC (med, months) 24 33 27 18 <0.001 Visceral metastases 400 (63%) 3543 (59%) 2148 (58%) 1484 (56%) 0.012 Subtype HR+HER2- 354 (56%) 3566 (59%) 2311 (62%) 1633 (62%) 0.000 HER2+ 131 (21%) 1295 (21%) 725 (20%) 545 (21%) TNBC 105 (16%) 860 (14%) 499 (13%) 345 (13%) >3 metastatic sites 180 (28%) 1306 (22%) 753 (20%) 553 (21%) 0.000 Median OS (95% CI) 33 (29-40) 47 (45-49) 49 (47-51) 48 (45-51) Unlike in early-stage BC, overweight and obesity do not seem associated with poorer OS in MBC women, whatever the subtype, on the opposite of underweight. The authors. Has not received any funding. M. Robain: Research grant / Funding (institution), ESME plateform support: Roche; Research grant / Funding (institution), ESME plateform support: AstraZeneca; Research grant / Funding (institution), ESME plateform support: Pfizer; Research grant / Funding (institution), ESME plateform support: BMS; Research grant / Funding (institution), ESME plateform support: DAIICHI Sankyo. All other authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]