1. Incidence of cancer and overall risk of mortality in individuals treated with raltegravir-based and non-raltegravir-based combination antiretroviral therapy regimens
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[ 1 ] UCL, Ctr Clin Res Modelling & Epidemiol, Inst Global Hlth, Res Dept Infect & Populat Hlth,Med Sch, Royal Free Campus,Rowland Hill St, London NW3 2PF, England Show more [ 2 ] Med Univ Innsbruck, Innsbruck, Austria Show more [ 3 ] Charles Univ Prague, Dept Infect & Trop Dis, Fac Med 3, Prague, Czech Republic [ 4 ] Na Bulovce Hosp, Prague, Czech Republic [ 5 ] West Tallinn Cent Hosp, Tallinn, Estonia Show more [ 6 ] Helsinki Univ Hosp, Helsinki, Finland Show more [ 7 ] Univ Nice Sophia Antipolis, LArchet Hosp 1, Nice, France Show more [ 8 ] Univ Copenhagen, Rigshosp, Copenhagen, Denmark Show more [ 9 ] Hippokrateion Hosp, Athens, Greece Show more [ 10 ] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany [ 11 ] German Ctr Infect Res DZIF, Partner Site Bonn Cologne, Cologne, Germany Show more [ 12 ] Ichilov Hosp, Tel Aviv, Israel [ 13 ] Kantonsspital St Gallen, St Gallen, Switzerland Show more [ 14 ] Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland Show more [ 15 ] Landspitali Univ Hosp, Reykjavik, Iceland [ 16 ] Ctr HIV AIDS & Infect Dis, Kaliningrad, Russia Show more [ 17 ] Charles Univ Prague, Fac Med 1, Dept Infect & Trop Dis, Prague, Czech Republic Show more [ 18 ] Med Univ Bialystok, Dept Infect Dis & Hepatol, Bialystok, Poland [ 19 ] Ida Viru Cent Hosp, Kohtla Jarve, Estonia [ 20 ] Infectol Ctr Latvia, Riga, Latvia [ 21 ] Dr Victor Babes Hosp, Bucharest, Romania Show more [ 22 ] Hosp JM Ramos Mejia, Buenos Aires, DF, Argentina, Centre for Clinical Research, Modelling and Epidemiology; Research Department of Infection and Population Health; Institute for Global Health; University College London Medical School; Royal Free Campus London UK, Medical University Innsbruck; Innsbruck Austria, Department of Infectious and Tropical Diseases; Third Faculty of Medicine; Charles University and Na Bulovce Hospital; Prague Czech Republic, West-Tallinn Central Hospital; Tallinn Estonia, Helsinki University Hospital; Helsinki Finland, L'Archet 1 Hospital; University of Nice Sophia-Antipolis; Nice France, Rigshospitalet; University of Copenhagen; Copenhagen Denmark, Ippokration General Hospital; Athens Greece, Department of Internal Medicine 1; University Hospital of Cologne; Cologne Germany, Ichilov Hospital; Tel Aviv-Yafo Israel, Kantonsspital St. Gallen; St. Gallen Switzerland, Faculty of Medicine; School of Health Sciences; University of Iceland; Reykjavik, Iceland and Landspitali University Hospital; Reykjavík Iceland, Centre for HIV/AIDS and infectious diseases; Kaliningrad Russian Federation, Department of Infectious and Tropical Diseases; First Faculty of Medicine; Charles University and Na Bulovce Hospital; Prague Czech Republic, Department of Infectious Diseases and Hepatology; Medical University of Bialystok; Bialystok Poland, Ida-Viru Central Hospital; Kohtla-Jarve, Infectology Center of Latvia; Riga Latvia, Dr. Victor Babes Hospital; Bucureşti Romania, Hospital J.M. Ramos Mejia; Buenos Aires Argentina, Cozzi-Lepri, A, Zangerle, R, Machala, L, Zilmer, K, Ristola, M, Pradier, C, Kirk, O, Sambatakou, H, Fätkenheuer, G, Yust, I, Schmid, P, Gottfredsson, M, Khromova, I, Jilich, D, Flisiak, R, Smidt, J, Rozentale, B, Radoi, R, Losso, MH, Lundgren, JD, Mocroft, A, [ 1 ] UCL, Ctr Clin Res Modelling & Epidemiol, Inst Global Hlth, Res Dept Infect & Populat Hlth,Med Sch, Royal Free Campus,Rowland Hill St, London NW3 2PF, England Show more [ 2 ] Med Univ Innsbruck, Innsbruck, Austria Show more [ 3 ] Charles Univ Prague, Dept Infect & Trop Dis, Fac Med 3, Prague, Czech Republic [ 4 ] Na Bulovce Hosp, Prague, Czech Republic [ 5 ] West Tallinn Cent Hosp, Tallinn, Estonia Show more [ 6 ] Helsinki Univ Hosp, Helsinki, Finland Show more [ 7 ] Univ Nice Sophia Antipolis, LArchet Hosp 1, Nice, France Show more [ 8 ] Univ Copenhagen, Rigshosp, Copenhagen, Denmark Show more [ 9 ] Hippokrateion Hosp, Athens, Greece Show more [ 10 ] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany [ 11 ] German Ctr Infect Res DZIF, Partner Site Bonn Cologne, Cologne, Germany Show more [ 12 ] Ichilov Hosp, Tel Aviv, Israel [ 13 ] Kantonsspital St Gallen, St Gallen, Switzerland Show more [ 14 ] Univ Iceland, Sch Hlth Sci, Fac Med, Reykjavik, Iceland Show more [ 15 ] Landspitali Univ Hosp, Reykjavik, Iceland [ 16 ] Ctr HIV AIDS & Infect Dis, Kaliningrad, Russia Show more [ 17 ] Charles Univ Prague, Fac Med 1, Dept Infect & Trop Dis, Prague, Czech Republic Show more [ 18 ] Med Univ Bialystok, Dept Infect Dis & Hepatol, Bialystok, Poland [ 19 ] Ida Viru Cent Hosp, Kohtla Jarve, Estonia [ 20 ] Infectol Ctr Latvia, Riga, Latvia [ 21 ] Dr Victor Babes Hosp, Bucharest, Romania Show more [ 22 ] Hosp JM Ramos Mejia, Buenos Aires, DF, Argentina, Centre for Clinical Research, Modelling and Epidemiology; Research Department of Infection and Population Health; Institute for Global Health; University College London Medical School; Royal Free Campus London UK, Medical University Innsbruck; Innsbruck Austria, Department of Infectious and Tropical Diseases; Third Faculty of Medicine; Charles University and Na Bulovce Hospital; Prague Czech Republic, West-Tallinn Central Hospital; Tallinn Estonia, Helsinki University Hospital; Helsinki Finland, L'Archet 1 Hospital; University of Nice Sophia-Antipolis; Nice France, Rigshospitalet; University of Copenhagen; Copenhagen Denmark, Ippokration General Hospital; Athens Greece, Department of Internal Medicine 1; University Hospital of Cologne; Cologne Germany, Ichilov Hospital; Tel Aviv-Yafo Israel, Kantonsspital St. Gallen; St. Gallen Switzerland, Faculty of Medicine; School of Health Sciences; University of Iceland; Reykjavik, Iceland and Landspitali University Hospital; Reykjavík Iceland, Centre for HIV/AIDS and infectious diseases; Kaliningrad Russian Federation, Department of Infectious and Tropical Diseases; First Faculty of Medicine; Charles University and Na Bulovce Hospital; Prague Czech Republic, Department of Infectious Diseases and Hepatology; Medical University of Bialystok; Bialystok Poland, Ida-Viru Central Hospital; Kohtla-Jarve, Infectology Center of Latvia; Riga Latvia, Dr. Victor Babes Hospital; Bucureşti Romania, Hospital J.M. Ramos Mejia; Buenos Aires Argentina, Cozzi-Lepri, A, Zangerle, R, Machala, L, Zilmer, K, Ristola, M, Pradier, C, Kirk, O, Sambatakou, H, Fätkenheuer, G, Yust, I, Schmid, P, Gottfredsson, M, Khromova, I, Jilich, D, Flisiak, R, Smidt, J, Rozentale, B, Radoi, R, Losso, MH, Lundgren, JD, and Mocroft, A
- Abstract
To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files, OBJECTIVES: There are currently few data on the long-term risk of cancer and death in individuals taking raltegravir (RAL). The aim of this analysis was to evaluate whether there is evidence for an association. METHODS: The EuroSIDA cohort was divided into three groups: those starting RAL-based combination antiretroviral therapy (cART) on or after 21 December 2007 (RAL); a historical cohort (HIST) of individuals adding a new antiretroviral (ARV) drug (not RAL) to their cART between 1 January 2005 and 20 December 2007, and a concurrent cohort (CONC) of individuals adding a new ARV drug (not RAL) to their cART on or after 21 December 2007. Baseline characteristics were compared using logistic regression. The incidences of newly diagnosed malignancies and death were compared using Poisson regression. RESULTS: The RAL cohort included 1470 individuals [with 4058 person-years of follow-up (PYFU)] compared with 3787 (4472 PYFU) and 4467 (10 691 PYFU) in the HIST and CONC cohorts, respectively. The prevalence of non-AIDS-related malignancies prior to baseline tended to be higher in the RAL cohort vs. the HIST cohort [adjusted odds ratio (aOR) 1.31; 95% confidence interval (CI) 0.95-1.80] and vs. the CONC cohort (aOR 1.89; 95% CI 1.37-2.61). In intention-to-treat (ITT) analysis (events: RAL, 50; HIST, 45; CONC, 127), the incidence of all new malignancies was 1.11 (95% CI 0.84-1.46) per 100 PYFU in the RAL cohort vs. 1.20 (95% CI 0.90-1.61) and 0.83 (95% CI 0.70-0.99) in the HIST and CONC cohorts, respectively. After adjustment, there was no evidence for a difference in the risk of malignancies [adjusted rate ratio (RR) 0.73; 95% CI 0.47-1.14 for RALvs. HIST; RR 0.95; 95% CI 0.65-1.39 for RALvs. CONC] or mortality (adjusted RR 0.87; 95% CI 0.53-1.43 for RALvs. HIST; RR 1.14; 95% CI 0.76-1.72 for RALvs. CONC). CONCLUSIONS: We found no evidence for an oncogenic risk or poorer survival associated with using RAL compared with control groups.