ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Association of Immunosuppression and Human Immunodeficiency Virus (HIV) Viremia With Anal Cancer Risk in Persons Living With HIV in the United States and Canada.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 39 citations in OpenAlex.
- Evaluation of Anal Cancer Screening Among 18-to-34-Year-Old Men Who Have Sex With Men Living With HIV Over a 10-Year Period.Open forum infectious diseases · 2026Article
- Risk of Cancer in People With HIV Experiencing Varying Degrees of Immune Recovery With Sustained Virological Suppression on Antiretroviral Treatment for More Than 2 Years: An International, Multicenter, Observational Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Observational
- Immunodeficiency, HIV Viremia, and Incident Anal Cancer Among People With HIV in South Africa.Open forum infectious diseases · 2025Article
- 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
- Differences in Trends in Cancer Incidence Rates Among People With HIV During 2001-2019 by Race and Ethnicity and by Risk Group in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Human Papillomavirus Type 16 E6 Seroprevalence among Men Living with HIV without HPV-Driven Malignancies.Cancer prevention research (Philadelphia, Pa.) · 2025Article
- Prevalence of HPV in anal cancer: exploring the role of infection and inflammation.Infectious agents and cancer · 2024Review
- Clinical Predictors and Outcomes of Invasive Anal Cancer for People With HIV in an Inception Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Autoimmune disease and the risk of anal cancer in the US population aged 66 years and over.Journal of the National Cancer Institute · 2024Article
- Post-marketing surveillance study of the safety of the HPV-16/18 vaccine in Korea (2017-2021).Human vaccines & immunotherapeutics · 2023Article
- Cumulative incidence of anal cancer since HIV or AIDS diagnosis in the United States.Journal of the National Cancer Institute · 2023Article
- Higher Neutrophil-to-Lymphocyte Ratio (NLR) Is a Preoperative Inflammation Biomarker of Poor Prognosis in HIV-Infected Patients with Colorectal Cancer: A Retrospective Study.Canadian journal of gastroenterology & hepatology · 2023Article
- HPV status and HPV16 viral load in anal cancer and its association with clinical outcome.Cancer medicine · 2022Article
- Impact of HIV on Anal Squamous Cell Carcinoma Rates in the United States, 2001-2015.Journal of the National Cancer Institute · 2022Article
- Room to Grow: The Need for Cancer Site-Specific Research Into Biomarkers of Aging and Immunity in People With HIV.Journal of the National Cancer Institute · 2022Article
- Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012.HIV medicine · 2022Article
- Anal squamous cell carcinoma: Impact of radiochemotherapy evolution over years and an explorative analysis of MRI prediction of tumor response in a mono-institutional series of 131 patients.Frontiers in oncology · 2022Article
- Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- 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
- Timing of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
Corrections and comments
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Authors and funding
24 authors at 13 institutions in 3 countries.
Funding
Abstract
backgroundPeople living with human immunodeficiency virus (HIV; PLWH) have a markedly elevated anal cancer risk, largely due to loss of immunoregulatory control of oncogenic human papillomavirus infection. To better understand anal cancer development and prevention, we determined whether recent, past, cumulative, or nadir/peak CD4+ T-cell count (CD4) and/or HIV-1 RNA level (HIV RNA) best predict anal cancer risk.
methodsWe studied 102 777 PLWH during 1996-2014 from 21 cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. Using demographics-adjusted, cohort-stratified Cox models, we assessed associations between anal cancer risk and various time-updated CD4 and HIV RNA measures, including cumulative and nadir/peak measures during prespecified moving time windows. We compared models using the Akaike information criterion.
resultsCumulative and nadir/peak CD4 or HIV RNA measures from approximately 8.5 to 4.5 years in the past were generally better predictors for anal cancer risk than their corresponding more recent measures. However, the best model included CD4 nadir (ie, the lowest CD4) from approximately 8.5 years to 6 months in the past (hazard ratio [HR] for <50 vs ≥500 cells/µL, 13.4; 95% confidence interval [CI], 3.5-51.0) and proportion of time CD4 <200 cells/µL from approximately 8.5 to 4.5 years in the past (a cumulative measure; HR for 100% vs 0%, 3.1; 95% CI, 1.5-6.6).
conclusionsOur results are consistent with anal cancer promotion by severe, prolonged HIV-induced immunosuppression. Nadir and cumulative CD4 may represent useful markers for identifying PLWH at higher anal cancer risk.
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