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Background: Immediate initiation of antiretroviral therapy (ART) regardless of CD4 cell count reduces risk for AIDS and non-AIDS-related events in asymptomatic, HIV-positive persons and is the standard of care. However, most HIV-positive persons initiate ART when their CD4 count decreases below 500 × 109 cells/L. Consequences of delayed ART on risk for non-AIDS-defining and AIDS-defining cancer, one of the most common reasons for death in HIV, are unclear. Objective: To estimate the long-term risk difference for cancer with the immediate ART strategy. Design: Multinational prospective cohort study. Setting: The D:A:D (Data collection on Adverse events of anti-HIV Drugs) study, which included HIV-positive persons from Europe, Australia, and the United States. Participants: 8318 HIV-positive persons with at least 1 measurement each of CD4 cell count and viral load while ART-naive (study period, 2006 to 2016). Measurements: The parametric g-formula was used, with adjustment for baseline and time-dependent confounders (CD4 cell count and viral load), to assess the 10-year risk for non-AIDS-defining and AIDS-defining cancer of immediate versus deferred (at CD4 counts < 350 and < 500 × 109 cells/L) ART initiation strategies. Results: During 64 021 person-years of follow-up, 231 cases of non-AIDS-defining cancer and 272 of AIDS-defining cancer occurred among HIV-positive persons with a median age of 36 years (interquartile range, 29 to 43 years). With immediate ART, the 10-year risk for non-AIDS-defining cancer was 2.97% (95% CI, 2.37% to 3.50%) and that for AIDS-defining cancer was 2.50% (CI, 2.37% to 3.38%). Compared with immediate ART initiation, the 10-year absolute risk differences when deferring ART to CD4 counts less than 500 × 109 cells/L and less than 350 × 109 cells/L were 0.12 percentage point (CI, -0.01 to 0.26 percentage point) and 0.29 percentage point (CI, -0.03 to 0.73 percentage point), respectively, for non-AIDS-defining cancer and 0.32 percentage point (CI, 0.21 to 0.44 percentage point) and 1.00 percentage point (CI, 0.67 to 1.44 percentage points), respectively, for AIDS-defining cancer. Limitation: Potential residual confounding due to observational study design. Conclusion: In this young cohort, effects of immediate ART on 10-year risk for cancer were small, and further supportive data are needed for non-AIDS-defining cancer. Primary Funding Source: Highly Active Antiretroviral Therapy Oversight Committee.
Chammartin, F., Lodi, S., Logan, R., Ryom, L., Mocroft, A., Kirk, O., et al. (2021). Risk for non-AIDS-defining and AIDS-defining cancer of early versus delayed initiation of antiretroviral therapy: A multinational prospective cohort study. ANNALS OF INTERNAL MEDICINE, 174(6), 768-776 [10.7326/M20-5226].
Risk for non-AIDS-defining and AIDS-defining cancer of early versus delayed initiation of antiretroviral therapy: A multinational prospective cohort study
Chammartin F.;Lodi S.;Logan R.;Ryom L.;Mocroft A.;Kirk O.;D'Arminio Monforte A.;Reiss P.;Phillips A.;El-Sadr W.;Hatleberg C. I.;Pradier C.;Bonnet F.;Law M.;De Wit S.;Sabin C.;Lundgren J. D.;Bucher H. C.
;Calvo G.;Dabis F.;Morfeldt L.;Weber R.;Lind-Thomsen A.;Salbol Brandt R.;Hillebreght M.;Zaheri S.;Wit F. W. N. M.;Scherrer A.;Schoni-Affolter F.;Rickenbach M.;Tavelli A.;Fanti I.;Leleux O.;Mourali J.;Le Marec F.;Boerg E.;Thulin E.;Sundstrom A.;Bartsch G.;Thompsen G.;Necsoi C.;Delforge M.;Fontas E.;Caissotti C.;Dollet K.;Mateu S.;Torres F.;Petoumenos K.;Blance A.;Huang R.;Puhr R.;Gronborg Laut K.;Kristensen D.;Kamara D. A.;Smith C. J.;Raben D.;Matthews C.;Bojesen A.;Grevsen A. L.;Powderly B.;Shortman N.;Moecklinghoff C.;Reilly G.;Smit C.;Ross M.;Fux C. A.;Morlat P.;Friis-Moller N.;Kowalska J.;Bohlius J.;Bower M.;Fatkenheuer G.;Grulich A.;Sjol A.;Meidahl P.;Iversen J. S.;Hillebregt M.;Prins J. M.;Kuijpers T. W.;Scherpbier H. J.;Van Der Meer J. T. M.;Godfried M. H.;Van Der Poll T.;Nellen F. J. B.;Geerlings S. E.;Van Vugt M.;Pajkrt D.;Bos J. C.;Wiersinga W. J.;Van Der Valk M.;Goorhuis A.;Hovius J. W.;Van Eden J.;Henderiks A.;Van Hes A. M. H.;Mutschelknauss M.;Nobel H. E.;Pijnappel F. J. J.;Jurriaans S.;Back N. K. T.;Zaaijer H. L.;Berkhout B.;Cornelissen M. T. E.;Schinkel C. J.;Thomas X. V.;Van Den Berge M.;Stegeman A.;Baas S.;Hage De Looff L.;Versteeg D.;Pronk M. J. H.;Ammerlaan H. S. M.;de Munnik E. S.;Jansz A. R.;Tjhie J.;Wegdam M. C. A.;Deiman B.;Scharnhorst V.;Van Der Plas A.;Weijsenfeld A. M.;Van Der Ende M. E.;de Vries-Sluijs T. E. M. S.;van Gorp E. C. M.;Schurink C. A. M.;Nouwen J. L.;Verbon A.;Rijnders B. J. A.;Bax H. I.;Van Der Feltz M.;Bassant N.;Van Beek J. E. A.;Vriesde M.;Van Zonneveld L. M.;De Oude-Lubbers A.;Van Den Berg-Cameron H. J.;Bruinsma-Broekman F. B.;de Groot J.;De Zeeuw-De Man M.;Boucher C. A. B.;Koopmans M. P. G.;van Kampen J. J. A.;Pas S. D.;Driessen G. J. A.;van Rossum A. M. C.;Van Der Knaap L. C.;Visser E.;Branger J.;Rijkeboer-Mes A.;Duijf-Van De Ven C. J. H. M.;Schippers E. F.;van Nieuwkoop C.;van IJperen J. M.;Geilings J.;van der Hut G.;Franck P. F. H.;Van Eeden A.;Brokking W.;Groot M.;Elsenburg L. J. M.;Damen M.;Kwa I. S.;Groeneveld P. H. P.;Bouwhuis J. W.;Van Den Berg J. F.;Van Hulzen A. G. W.;Van Der Bliek G. L.;Bor P. C. J.;Bloembergen P.;Wolfhagen M. J. H. M.;Ruijs G. J. H. M.;Kroon F. P.;De Boer M. G. J.;Bauer M. P.;Jolink H.;Vollaard A. M.;Dorama W.;Van Holten N.;Claas E. C. J.;Wessels E.;Den Hollander J. G.;Pogany K.;Roukens A.;Kastelijns M.;Smit J. V.;Smit E.;Struik-Kalkman D.;Tearno C.;Bezemer M.;van Niekerk T.;Pontesilli O.;Lowe S. H.;Oude Lashof A. M. L.;Posthouwer D.;Ackens R. P.;Schippers J.;Vergoossen R.;Weijenberg-Maes B.;van Loo I. H. M.;Havenith T. R. A.;Leyten E. M. S.;Gelinck L. B. S.;van Hartingsveld A.;Meerkerk C.;Wildenbeest G. S.;Mutsaers J. A. E. M.;Jansen C. L.;Mulder J. W.;Vrouenraets S. M. E.;Lauw F. N.;van Broekhuizen M. C.;Paap H.;Vlasblom D. J.;Smits P. H. M.;Weijer S.;El Moussaoui R.;Bosma A. S.;van Vonderen M. G. A.;van Houte D. P. F.;Kampschreur L. M.;Dijkstra K.;Faber S.;Weel J.;Kootstra G. J.;Delsing C. E.;van der Burg-Van de Plas M.;Heins H.;Lucas E.;Kortmann W.;van Twillert G.;Cohen Stuart J. W. T.;Diederen B. M. W.;van Truijen-Oud F. A.;van der Reijden W. A.;Jansen R.;Brinkman K.;van den Berk G. E. L.;Blok W. L.;Frissen P. H. J.;Lettinga K. D.;Schouten W. E. M.;Veenstra J.;Brouwer J. C.;Geerders F. G.;Hoeksema K.;Kleene J. M.;van der Meche B. I.;Spelbrink M.;Sulman H.;Toonen A. J. M.;Wijnands S.;Kwa D.;Witte E.;Koopmans P. P.;Keuter M.;van der Ven A. J. A. M.;ter Hofstede H. J. M.;Dofferhoff A. S. M.;van Crevel R.;Albers M.;Bosch M. E. W.;Grintjes-Huisman K. J. T.;Zomer J. B.;Stelma F. F.;Rahamat-Langendoen J.;Burger D.;Richter C.;Gisolf H. E.;Hassing J. R.;ter Beest G.;van Bentum P. H. M.;Langebeek N.;Tiemessen R.;Swanink C. M. A.;van Lelyveld S. F. L.;Soetekouw R.;Hulshoff N.;van der Prijt L. M. M.;van der Swaluw J.;Bermon N.;Herpers B. L.;Veenendaal D.;Verhagen W. D. M.;van Wijk M.;van Kasteren M. E. E.;Brouwer E. A.;de Kruijf-Van de Wiel B. A. F. M.;Kuipers M.;Santegoets R. M. W. J.;van der Ven B.;Marcelis H. J.;Buiting A. G. M.;Kabel J. P.;Bierman W. F. W.;Scholvinck H.;Wilting R. K.;Stienstra Y.;de Groot-De Jonge H.;van der Meulen A. P.;de Weerd A. D.;Ludwig-Roukema J.;Niesters H. G. M.;Riezebos-Brilman A.;van Leer-Buter C. C.;Knoester M.;Hoepelman A. I. M.;Mudrikova T.;Ellerbroek M. P.;Oosterheert J. J.;Arends E. J.;Barth E. R.;Wassenberg M. W. M.;Schadd M. E.;van Elst-Laurijssen D. H. M.;van Oers-Hazelzet B. E.;Vervoort S.;van Berkel M.;Schuurman R.;Verduyn-Lunel F.;Wensing A. M. J.;Peters E. J. G.;van Agtmael A. M.;Bomers M.;de Vocht J.;Heitmuller M.;Laan M. L.;Pettersson M. A.;Vandenbroucke-Grauls C. M. J. E.;Ang W. C.;Geelen S. P. M.;Wolfs T. F. W.;Bont J. L.;Nauta N.;Bezemer O. D.;van Sighem I. A.;Boender S. T.;de Jong A.;Bergsma D.;Hoekstra P.;de Lang A.;Grivell S.;Jansen A.;Rademaker J. M.;Raethke M.;Meijering R.;Schnorr S.;de Groot L.;van den Akker M.;Bakker Y.;Claessen E.;El Berkaoui A.;Koops J.;Kruijne E.;Lodewijk C.;Munjishvili L.;Peeck B.;Ree C.;Regtop R.;Ruijs Y.;Rutkens T.;van de Sande L.;Schoorl M.;Timmerman A.;Tuijn E.;Veenenberg L.;van der Vliet S.;Wisse A.;Woudstra T.;Tuk B.;Dupon M.;Gaborieau V.;Lacoste D.;Malvy D.;Mercie P.;Neau D.;Pellegrin L. J.;Tchamgoue S.;Lazaro E.;Cazanave C.;Vandenhende M.;Vareil O. M.;Gerard Y.;Blanco P.;Bouchet S.;Breilh D.;Fleury H.;Pellegrin I.;Chene G.;Thiebaut R.;Wittkop L.;Lawson-Ayayi S.;Gimbert A.;Desjardin S.;Lacaze-Buzy L.;Petrov-Sanchez V.;Andre N.;Bernard K.;Caubet O.;Caunegre L.;Chossat I.;Courtault C.;Dauchy A. F.;Dondia D.;Duffau P.;Dutronc H.;Farbos S.;Faure I.;Ferrand H.;Greib C.;Hessamfar M.;Imbert Y.;Lataste P.;Marie J.;Mechain M.;Monlun E.;Ochoa A.;Pistone T.;Raymond I.;Receveur C. M.;Rispal P.;Sorin L.;Valette C.;Viallard J. F.;Wille H.;Wirth G.;Lafon M.;Trimoulet P.;Bellecave P.;Tumiotto C.;Haramburu F.;Miremeont-Salame G.;Blaizeau J. M.;Decoin M.;Hannapier C.;Lenaud E.;Pougetoux A.;Delveaux S.;D'Ivernois C.;Diarra F.;Uwamaliya-Nziyumvira B.;Palmer G.;Conte V.;Sapparrart V.;Moore R.;Edwards S.;Hoy J.;Watson K.;Roth N.;Lau H.;Bloch M.;Baker D.;Carr A.;Cooper D.;O'Sullivan M.;Nolan D.;Guelfi G.;Domingo P.;Sambeat A. M.;Gatell J.;Del Cacho E.;Cadafalch J.;Fuster M.;Codina C.;Sirera G.;Vaque A.;Delforge M.;Clumeck N.;Gennotte F. A.;Gerard M.;Kabeya K.;Konopnicki D.;Libois A.;Martin C.;Payen C. M.;Semaille P.;Van Laethem Y.;Neaton J.;El-Sadr M. W.;Krum E.;Thompson G.;Wentworth D.;Luskin-Hawk R.;Telzak E.;Abrams I. D.;Cohn D.;Markowitz N.;Arduino R.;Mushatt D.;Friedland G.;Perez G.;Tedaldi E.;Fisher E.;Gordin F.;Crane R. L.;Sampson J.;Baxter J.;Gazzard B.;Horban A.;Karpov I.;Pedersen C.;Ristola M.;Rockstroh J.;Peters L.;Fischer H. A.;Larsen F. J.;Podlekareva D.;Cozzi-Lepri A.;Shepherd L.;Schultze A.;Amele S.;Losso M.;Kundro M.;Schmied B.;Zangerle R.;Vassilenko A.;Mitsura M. V.;Paduto D.;Florence E.;Vandekerckhove L.;Hadziosmanovic V.;Begovac J.;Machala L.;Jilich D.;Sedlacek D.;Kronborg G.;Benfield T.;Gerstoft J.;Katzenstein T.;Moller F. N.;Ostergaard L.;Wiese L.;Nielsen N. L.;Zilmer K.;Smidt J.;Aho I.;Viard J. P.;Girard P. M.;Duvivier C.;Schmidt R.;Degen O.;Stellbrink J. H.;Stefan C.;Bogner J.;Fatkenheuer G.;Chkhartishvili N.;Gargalianos P.;Xylomenos G.;Armenis K.;Sambatakou H.;Szlavik J.;Gottfredsson M.;Mulcahy F.;Yust I.;Turner D.;Burke M.;Shahar E.;Hassoun G.;Elinav H.;Haouzi M.;Elbirt D.;Sthoeger M. Z.;Esposito R.;Mazeu I.;Mussini C.;Mazzotta F.;Gabbuti A.;Vullo V.;Lichtner M.;Zaccarelli M.;Antinori A.;Acinapura R.;Plazzi M.;Lazzarin A.;Castagna A.;Gianotti N.;Galli M.;Ridolfo A.;Rozentale B.;Uzdaviniene V.;Matulionyte R.;Staub T.;Hemmer R.;Ormaasen V.;Maeland A.;Bruun J.;Knysz B.;Gasiorowski J.;Inglot M.;Bakowska E.;Flisiak R.;Grzeszczuk A.;Parczewski M.;Maciejewska K.;Aksak-Was B.;Beniowski M.;Mularska E.;Smiatacz T.;Gensing M.;Jablonowska E.;Malolepsza E.;Wojcik K.;Mozer-Lisewska I.;Caldeira L.;Mansinho K.;Maltez F.;Radoi R.;Oprea C.;Panteleev A.;Panteleev O.;Yakovlev A.;Trofimora T.;Khromova I.;Kuzovatova E.;Borodulina E.;Vdoushkina E.;Jevtovic D.;Tomazic J.;Miro M. J.;Moreno S.;Rodriguez J. M.;Clotet B.;Jou A.;Paredes R.;Tural C.;Puig J.;Bravo I.;Gutierrez M.;Mateo G.;Laporte M. J.;Falconer K.;Thalme A.;Sonnerborg A.;Blaxhult A.;Flamholc L.;Cavassini M.;Calmy A.;Furrer H.;Battegay M.;Schmid P.;Kuznetsova A.;Kyselyova G.;Sluzhynska M.;Johnson A. M.;Simons E.;Orkin C.;Weber J.;Scullard G.;Clarke A.;Leen C.;Thulin G.;Sundstrom A.;Akerlund B.;Koppel K.;Karlsson A.;Hakangard C.;Castelli F.;Cauda R.;Di Perri G.;Iardino R.;Ippolito G.;Marchetti C. G.;Perno F. C.;von Schloesser F.;Viale P.;Antinori A.;Ceccherini-Silberstein F.;Girardi E.;Lo Caputo S.;Puoti M.;Andreoni M.;Ammassari A.;Balotta C.;Bandera A.;Bonfanti P.;Bonora S.;Borderi M.;Calcagno A.;Calza L.;Capobianchi R. M.;Cingolani A.;Cinque P.;De Luca A.;Di Biagio A.;Gori A.;Guaraldi G.;Lapadula G.;Madeddu G.;Maggiolo F.;Marcotullio S.;Monno L.;Nozza S.;Quiros Roldan E.;Rossotti R.;Rusconi S.;Santoro M. M.;Saracino A.;Galli L.;Lorenzini P.;Rodano A.;Shanyinde M.;Carletti F.;Carrara S.;Di Caro A.;Graziano S.;Petrone F.;Prota G.;Quartu S.;Truffa S.;Giacometti A.;Costantini A.;Barocci V.;Angarano G.;Santoro C.;Suardi C.;Donati V.;Verucchi G.;Minardi C.;Quirino T.;Abeli C.;Manconi E. P.;Piano P.;Cacopardo B.;Celesia B.;Vecchiet J.;Falasca K.;Pan A.;Lorenzotti S.;Sighinolfi L.;Segala D.;Vichi F.;Cassola G.;Viscoli C.;Alessandrini A.;Bobbio N.;Mazzarello G.;Mastroianni C.;Belvisi V.;Caramma I.;Chiodera A.;Milini P.;Rizzardini G.;Moioli C. M.;Piolini R.;Ridolfo L. A.;Salpietro S.;Tincati C.;Puzzolante C.;Abrescia N.;Chirianni A.;Borgia G.;Orlando R.;Bonadies G.;Di Martino F.;Gentile I.;Maddaloni L.;Cattelan M. A.;Marinello S.;Cascio A.;Colomba C.;Baldelli F.;Schiaroli E.;Parruti G.;Sozio F.;Magnani G.;Ursitti A. M.;Cristaudo A.;Baldin G.;Capozzi M.;Cicalini S.;Fontanelli Sulekova L.;Iaiani G.;Latini A.;Mastrorosa I.;Savinelli S.;Vergori A.;Cecchetto M.;Viviani F.;Bagella P.;Rossetti B.;Franco A.;Fontana Del Vecchio R.;Francisci D.;Di Giuli C.;Caramello P.;Orofino C. G.;Sciandra M.;Bassetti M.;Londero A.;Pellizzer G.;Manfrin V.;Starnini G.;Ialungo A.;Dellamonica P.;Bernard E.;Courjon J.;Cua E.;De Salvador-Guillouet F.;Durant J.;Etienne C.;Ferrando S.;Mondain-Miton V.;Naqvi A.;Perbost I.;Pillet S.;Prouvost-Keller B.;Pugliese P.;Rio V.;Risso K.;Roger M. P.;Aubert V.;Bernasconi E.;Ciuffi A.;Dollenmaier G.;Egger M.;Elzi L.;Fehr J.;Fellay J.;Gunthard F. H.;Haerry D.;Hasse B.;Hirsch H. H.;Hoffmann M.;Hosli I.;Kahlert C.;Kaiser L.;Keiser O.;Klimkait T.;Kouyos D. R.;Kovari H.;Ledergerber B.;Martinetti G.;Martinez de Tejada B.;Marzolini C.;Metzner J. K.;Muller N.;Nicca D.;Pantaleo G.;Paioni P.;Rauch A.;Rudin C.;Speck R.;Stockle M.;Tarr P.;Trkola A.;Vernazza P.;Wandeler G.;Yerly S.
2021
Abstract
Background: Immediate initiation of antiretroviral therapy (ART) regardless of CD4 cell count reduces risk for AIDS and non-AIDS-related events in asymptomatic, HIV-positive persons and is the standard of care. However, most HIV-positive persons initiate ART when their CD4 count decreases below 500 × 109 cells/L. Consequences of delayed ART on risk for non-AIDS-defining and AIDS-defining cancer, one of the most common reasons for death in HIV, are unclear. Objective: To estimate the long-term risk difference for cancer with the immediate ART strategy. Design: Multinational prospective cohort study. Setting: The D:A:D (Data collection on Adverse events of anti-HIV Drugs) study, which included HIV-positive persons from Europe, Australia, and the United States. Participants: 8318 HIV-positive persons with at least 1 measurement each of CD4 cell count and viral load while ART-naive (study period, 2006 to 2016). Measurements: The parametric g-formula was used, with adjustment for baseline and time-dependent confounders (CD4 cell count and viral load), to assess the 10-year risk for non-AIDS-defining and AIDS-defining cancer of immediate versus deferred (at CD4 counts < 350 and < 500 × 109 cells/L) ART initiation strategies. Results: During 64 021 person-years of follow-up, 231 cases of non-AIDS-defining cancer and 272 of AIDS-defining cancer occurred among HIV-positive persons with a median age of 36 years (interquartile range, 29 to 43 years). With immediate ART, the 10-year risk for non-AIDS-defining cancer was 2.97% (95% CI, 2.37% to 3.50%) and that for AIDS-defining cancer was 2.50% (CI, 2.37% to 3.38%). Compared with immediate ART initiation, the 10-year absolute risk differences when deferring ART to CD4 counts less than 500 × 109 cells/L and less than 350 × 109 cells/L were 0.12 percentage point (CI, -0.01 to 0.26 percentage point) and 0.29 percentage point (CI, -0.03 to 0.73 percentage point), respectively, for non-AIDS-defining cancer and 0.32 percentage point (CI, 0.21 to 0.44 percentage point) and 1.00 percentage point (CI, 0.67 to 1.44 percentage points), respectively, for AIDS-defining cancer. Limitation: Potential residual confounding due to observational study design. Conclusion: In this young cohort, effects of immediate ART on 10-year risk for cancer were small, and further supportive data are needed for non-AIDS-defining cancer. Primary Funding Source: Highly Active Antiretroviral Therapy Oversight Committee.
Chammartin, F., Lodi, S., Logan, R., Ryom, L., Mocroft, A., Kirk, O., et al. (2021). Risk for non-AIDS-defining and AIDS-defining cancer of early versus delayed initiation of antiretroviral therapy: A multinational prospective cohort study. ANNALS OF INTERNAL MEDICINE, 174(6), 768-776 [10.7326/M20-5226].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/352662
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 598/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
