7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013)

Abstract

WEPE504 - Poster Exhibition


Association between HMG-CoA reductase inhibitors (statins) use and cancer occurrence among HIV-1 treated patients

V. Spagnuolo1, L. Galli1, A. Poli1, L. Fumagalli1, N. Gianotti1, A. Carbone1, S. Nozza1, S. Bossolasco1, A. Lazzarin1,2, A. Castagna1

1IRCCS Ospedale San Raffaele, Infectious Diseases Department, Milan, Italy, 2Università Vita-Salute San Raffaele, Milan, Italy

Background: In the general population, statin use has been associated with reduced cancer-related mortality incidence. In HIV-infected patients (HIV+pts) previous reports showed a protective role of statins use on the mortality and non-Hodgkin´s lymphoma occurrence.We evaluated the effect of statin therapy on cancer occurrence among HIV+pts.
Methods: Retrospective longitudinal study on cART-experienced HIV+pts, not on treatment with statin at cART initiation, cancer-free at cART initiation and also at statin initiation, who attended our clinic until 30 September 2012. Follow-up was calculated from the date of cART initiation (baseline=BL) and censored at the date of first cancer diagnosis or loss to follow-up or death or last available visit, whichever occurred first. According to CDC-1993 classification, malignancies were divided into AIDS-defining (ADM) and non-AIDS-defining malignancies (NADM).
Results described as median (IQR). Multivariate analysis performed using Cox proportional hazard model.
Results: 5357 pts followed for 10.3 (4.8-15.1) years [76% males, age 47 (41-52) years, 15 (8-20) years since first HIV-positive test, 34% HCVAb-positive, on cART since 10 (5-15) years, nadir CD4 was 214 (96-323) cells/µL, BMI 23.4 (21.3-25.7) Kg/m2 , BL cholesterol 156 (132-185) mg/dL, BL triglycerides 117 (82-173) mg/dL, BL fasting glucose 86 (80-94) mg/dL].During 52663 person-years of follow-up (PYFU), 375 pts developed cancer [ADM: 194 (52%); NADM: 181 (48%)] for an overall crude incidence rate of 7.12 (95%CI: 6.42-7.86) per 1000PYFU; 740 (14%) patients used statin [duration: 24.7 (10.4-42.6) months; rosuvastatin used by 598 (79%) and pravastatin by 144 (19%) pts]. Cancer occurred in 12/740 (1.6%) statin users and in 363/4617 (7.9%) no-statin users (p< 0.0001); all cancers among statin users were NADM. Results from multivariate analysis on the risk of cancer occurrence are reported in the Table 1.
Conclusion: In this retrospective study on HIV-infected treated patients, the use of statin was associated with reduced risk of cancer.

Table 1
[Table 1]


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