Risks of Opportunistic Infections in People With Human Immunodeficiency Virus With Cancers Treated With Chemotherapy.
Cancer
Pneumocystis jirovecii pneumonia
chemotherapy
opportunistic infections
prophylaxis
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
18
04
2021
accepted:
17
07
2021
entrez:
30
8
2021
pubmed:
31
8
2021
medline:
31
8
2021
Statut:
epublish
Résumé
We ascertained incidence of opportunistic infections (OIs) in people with human immunodeficiency virus (PWH) with cancer undergoing chemotherapy with non-human immunodeficiency virus (HIV) comparators. We identified 2106 PWH and 2981 uninfected Veterans with cancer who received at least 1 dose of chemotherapy between 1996 and 2017 from the Veterans Aging Cohort Study. We ascertained incident OIs within 6 months of chemotherapy amongst zoster, cytomegalovirus, tuberculosis, We confirmed 106 OIs in 101 persons. Adjusted OI incidence rate ratios (IRRs) indicated higher risk in PWH for all cancers (IRR, 4.8; 95% confidence interval [CI], 2.8-8.2), hematological cancers (IRR, 8.2; 95% CI, 2.4-27.3), and nonhematological cancers (IRR, 3.9; 95% CI, 2.1-7.2). Incidence rate ratios were not significantly higher in those with CD4 >200 cells/mm Veterans with HIV undergoing chemotherapy had higher rates of OIs than uninfected Veterans, particularly those with hematological cancers, but not in PWH with HIV controlled disease. Our study does not support systematic PCP prophylaxis in solid tumors in PWH with HIV controlled disease.
Sections du résumé
BACKGROUND
BACKGROUND
We ascertained incidence of opportunistic infections (OIs) in people with human immunodeficiency virus (PWH) with cancer undergoing chemotherapy with non-human immunodeficiency virus (HIV) comparators.
METHODS
METHODS
We identified 2106 PWH and 2981 uninfected Veterans with cancer who received at least 1 dose of chemotherapy between 1996 and 2017 from the Veterans Aging Cohort Study. We ascertained incident OIs within 6 months of chemotherapy amongst zoster, cytomegalovirus, tuberculosis,
RESULTS
RESULTS
We confirmed 106 OIs in 101 persons. Adjusted OI incidence rate ratios (IRRs) indicated higher risk in PWH for all cancers (IRR, 4.8; 95% confidence interval [CI], 2.8-8.2), hematological cancers (IRR, 8.2; 95% CI, 2.4-27.3), and nonhematological cancers (IRR, 3.9; 95% CI, 2.1-7.2). Incidence rate ratios were not significantly higher in those with CD4 >200 cells/mm
CONCLUSIONS
CONCLUSIONS
Veterans with HIV undergoing chemotherapy had higher rates of OIs than uninfected Veterans, particularly those with hematological cancers, but not in PWH with HIV controlled disease. Our study does not support systematic PCP prophylaxis in solid tumors in PWH with HIV controlled disease.
Identifiants
pubmed: 34458394
doi: 10.1093/ofid/ofab389
pii: ofab389
pmc: PMC8391784
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofab389Subventions
Organisme : NCI NIH HHS
ID : R01 CA210806
Pays : United States
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Références
Intern Med. 2020 Apr 1;59(7):987-990
pubmed: 31839658
J Clin Oncol. 2018 Oct 20;36(30):3043-3054
pubmed: 30179565
AIDS. 2012 Jan 28;26(3):315-23
pubmed: 22112597
J Infect Dis. 2016 Sep 15;214(6):862-72
pubmed: 27559122
Blood. 2005 Mar 1;105(5):1891-7
pubmed: 15550484
Clin Infect Dis. 2013 Dec;57(11):1638-47
pubmed: 23899679
Lancet Infect Dis. 2019 Jun;19(6):e200-e212
pubmed: 30744963
J Antimicrob Chemother. 2016 Sep;71(9):2397-404
pubmed: 27550992
N Engl J Med. 2018 Mar 8;378(10):965
pubmed: 29514025
Med Care. 2004 Apr;42(4):355-60
pubmed: 15076812
Clin Infect Dis. 2015 Apr 15;60(8):1269-77
pubmed: 25601456
J Acquir Immune Defic Syndr. 2013 Apr 15;62(5):546-9
pubmed: 23314415
Clin Infect Dis. 2015 Feb 15;60(4):627-38
pubmed: 25362204
Blood. 2008 Apr 15;111(8):3986-90
pubmed: 18172004
Lancet Infect Dis. 2015 Jul;15(7):810-8
pubmed: 26070969
J Antimicrob Chemother. 2015 Jan;70(1):249-56
pubmed: 25223971
AIDS. 2014 Sep 10;28(14):2109-18
pubmed: 25265077
Lancet HIV. 2015 Mar;2(3):e98-106
pubmed: 26424550
J Infect Dis. 2013 Nov 1;208(9):1375-85
pubmed: 23908479
Clin Infect Dis. 2020 Oct 23;71(7):e125-e134
pubmed: 31677266
Lung Cancer. 2007 Aug;57(2):240-2
pubmed: 17400329
J Clin Oncol. 2013 Feb 20;31(6):794-810
pubmed: 23319691
AIDS. 2016 Jan;30(2):273-91
pubmed: 26691548
Leuk Lymphoma. 2018 Aug;59(8):1851-1860
pubmed: 29160731
AIDS. 2016 Jul 17;30(11):1795-806
pubmed: 27064994
Sex Transm Dis. 2010 Aug;37(8):512-8
pubmed: 20375927
AIDS. 2016 Mar 27;30(6):899-908
pubmed: 26959354
AIDS Res Hum Retroviruses. 2016 Jan;32(1):4-5
pubmed: 26325000
Eur Respir J. 2020 Aug 27;56(2):
pubmed: 32444410
Lancet. 2014 Jul 19;384(9939):241-8
pubmed: 25042234
Eur J Cancer. 2011 Nov;47(16):2403-7
pubmed: 21778048
J Natl Compr Canc Netw. 2018 Aug;16(8):986-1017
pubmed: 30099375
HIV Med. 2014 Mar;15 Suppl 2:1-92
pubmed: 24528810
Clin Infect Dis. 2017 Feb 15;64(4):468-475
pubmed: 27940936