ArticleJournal of acquired immune deficiency syndromes (1999)2025
The Association of Anemia on Non-AIDS-Defining Cancer and Subsequent Survival Among People With HIV After Antiretroviral Initiation.
Article in Journal of acquired immune deficiency syndromes (1999), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe association of anemia as a predictive and prognostic indicator of non-AIDS-defining cancer (NADC) among people with HIV (PWH) remains unknown. We evaluated the presence of anemia and its severity as a predictor of NADC and 5-year all-cause survival after an NADC diagnosis among PWH who had initiated antiretroviral therapy.
settingNorth American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).
methodsWe included PWH (≥18 years) on ART between January 01, 2007, and December 31, 2016, with no prior cancer diagnosis. Annual median hemoglobin was categorized into mild (11.0-12.9 g/dL men, 11.0-11.9 g/dL women) and moderate/severe (<10.9 g/dL regardless of sex) anemia. Discrete time-to-event models using a complementary log-log link estimated crude and adjusted hazards ratios (aHR) and 95% confidence intervals for NADC by anemia severity. Five-year mortality after NADC diagnosis by anemia was evaluated.
resultsAmong 67,228 PWH contributing 301,421 annual median hemoglobin observations, 244,658 (81%) were not anemic, 40,134 (13%) had mild, and 16,629 (6%) had moderate/severe anemia. The risk of NADC was higher among PWH with anemia (aHR 2.40 [2.19 to 2.63]) (vs. no anemia) and greater among men (aHR 2.42 [2.20 to 2.66]) than women (aHR 2.02 [1.42 to 2.89]). NADC risk increased with worsening anemia (mild: aHR 2.01 [1.81 to 2.23], moderate/severe: aHR 3.59 [3.13 to 4.11]). The 5-year all-cause mortality after NADC diagnosis was higher (aHR 1.37 [1.21 to 1.55]) among PWH with anemia.
conclusionsAmong PWH who initiated ART, anemia may serve as a predictive indicator of NADC risk. Identification of anemia should warrant investigations into the underlying etiology, including evaluation for NADC. Anemia is also a prognostic indicator among PWH diagnosed with NADC.
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