ArticlePloS one2018
Cancer risk in HIV patients with incomplete viral suppression after initiation of antiretroviral therapy.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Early antiretroviral therapy and long-term cancer risk in HIV: 9-year outcomes from the START randomized trial.BMC cancer · 2026Trial
- Characteristics and management of low-level viraemia in people living with HIV in a resource-limited setting: A multicentre retrospective study in Greece.HIV medicine · 2026Observational
- Has the Expected Shift in HIV-Related Cancers Occurred? Findings from a Long-Term HIV Cohort in Turkey.Journal of clinical medicine · 2026Article
- HIV-1 Viremia and Cancer Risk in 2.8 Million People: The South African HIV Cancer Match Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Circulating Biomarker Panorama in HIV-Associated Lymphoma: A Bridge from Early Risk Warning to Prognostic Stratification.Biomolecules · 2025Review
- Primary central nervous system lymphomas at a tertiary academic hospital in Johannesburg.Journal of the colleges of medicine of South Africa · 2025Article
- Invited commentary: mixing multiple imputation and bootstrapping for variance estimation.American journal of epidemiology · 2024Article
- Subtle Longitudinal Alterations in Env Sequence Potentiate Differences in Sensitivity to Broadly Neutralizing Antibodies following Acute HIV-1 Subtype C Infection.Journal of virology · 2022Article
- A retrospective study of distribution of HIV associated malignancies among inpatients from 2007 to 2020 in China.Scientific reports · 2021Article
- Cervical cancer prevention and control in women living with human immunodeficiency virus.CA: a cancer journal for clinicians · 2021Review
- Associations Between Plasma Human Immunodeficiency Virus (HIV) Ribonucleic Acid Levels and Incidence of Invasive Cancer in People With HIV After Initiation of Combination Antiretroviral Therapy.Open forum infectious diseases · 2021Article
- Burden of Chronic Conditions Among Persons with HIV/AIDS and Psychiatric Comorbidity.Current HIV research · 2021Article
- Protection of dopamine neurons by CDNF and neurturin variant N4 against MPP+ in dissociated cultures from rat mesencephalon.PloS one · 2021Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundCancer causes significant morbidity and mortality among HIV patients in the US due to extended life expectancy with access to effective antiretroviral therapy. Low, detectable HIV RNA has been studied as a risk factor for adverse health outcomes, but its clinical impact on cancer risk remains unclear. The objective of this study was to determine whether HIV RNA <1,000 copies/mL six months after starting therapy was associated with 10-year first cancer risk.
methodsWe followed 7,515 HIV therapy initiators from a US-based multicenter clinical cohort from 1998 to 2014. We used nonparametric multiple imputation to account for viral loads that fell below assay detection limits, and categorized viral loads six months after therapy initiation into four groups: <20, 20-199, 200-999, and >999 copies/mL. We calculated estimates of the cumulative incidence of cancer diagnosis, accounting for death as a competing event. Inverse probability of exposure and censoring weights were used to control for confounding and differential loss to follow up, respectively.
resultsCrude 10-year first cancer risk in the study sample was 7.03% (95% CI: 6.08%, 7.98%), with the highest risk observed among patients with viral loads between 200 and 999 copies/mL six months after ART initiation (10.7%). After controlling for baseline confounders, 10-year first cancer risk was 6.90% (95% CI: 5.69%, 8.12%), and was similar across viral load categories.
conclusionOverall risk of first cancer was not associated with incomplete viral suppression; however, cancer remains a significant threat to HIV patients after treatment initiation. As more HIV patients gain access to treatment in the current "treat all" era, occurrences of incomplete viral suppression will be observed more frequently in clinical practice, which supports continued study of the role of low-level HIV RNA on cancer development.
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