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:
Среди принимавших статины онкологические заболевания были зафиксированы значительно реже: 12 случаев на 740 пациентов (1,6%) против 363 случаев из 4617 (7,9%) среди не принимавших статины.
ДИ — доверительный интервал;
P — P-значение;