The impact of HIV on non-adherence for tamoxifen among women with breast cancer in South Africa.
Breast cancer
HIV
Non-adherence
Tamoxifen
Journal
Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
06
09
2022
accepted:
02
12
2022
pubmed:
21
12
2022
medline:
1
2
2023
entrez:
20
12
2022
Statut:
ppublish
Résumé
Women living with HIV (WLWH) and breast cancer (BC) have worse overall survival than HIV-negative women with BC, and poor adherence to prescribed tamoxifen is known to contribute to poor survival. We therefore investigated the association of HIV infection with adherence to adjuvant tamoxifen among women with localized hormone receptor (HR)-positive breast cancer in South Africa. Among 4,097 women diagnosed with breast cancer at six hospitals in the prospective South African Breast Cancer and HIV Outcomes (SABCHO) cohort study between July 2015 and December 2020, we focused on black women with stages I-III HR-positive breast cancer who were prescribed 20 mg of adjuvant tamoxifen daily. We collected venous blood once from each participant during a routine clinic visit, and analyzed concentrations of tamoxifen and its metabolites using a triple quadruple mass spectrometer. We defined non-adherence as a tamoxifen level < 60 ng/mL after 3 months of daily tamoxifen use. We compared tamoxifen-related side effects, and concurrent medication use among women with and without HIV and developed multivariable logistic regression models of tamoxifen non-adherence. Among 369 subjects, 78 (21.1%) were WLWH and 291 (78.9%) were HIV-negative. After a median (interquartile range) time of 13.0 (6.2-25.2) months since tamoxifen initiation, the tamoxifen serum concentration ranged between 1.54 and 943.0 ng/mL and 208 (56.4%) women were non-adherent to tamoxifen. Women < 40 years of age were more likely to be non-adherent than women > 60 years (73.4% vs 52.6%, odds ratio (OR) = 2.49, 95% confidence interval (CI) = 1.26-4.94); likewise, WLWH (70.5% vs 52.6%, OR = 2.16, 95% CI = 1.26-3.70) than HIV-negative women. In an adjusted model WLWH had twice the odds of non-adherence to tamoxifen, compared to HIV-negative women (OR = 2.40, 95% CI = 1.11-5.20). High rates of non-adherence to adjuvant tamoxifen may limit the overall survival of black South African women with HR-positive breast cancer, especially among WLWH.
Identifiants
pubmed: 36538247
doi: 10.1007/s10549-022-06835-6
pii: 10.1007/s10549-022-06835-6
pmc: PMC10149344
mid: NIHMS1891849
doi:
Substances chimiques
Tamoxifen
094ZI81Y45
Antineoplastic Agents, Hormonal
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
647-659Subventions
Organisme : NCI NIH HHS
ID : R01 CA192627
Pays : United States
Organisme : NIH HHS
ID : NIH/R01-CA19262701
Pays : United States
Organisme : National Cancer Institute of the National Institutes of Health
ID : K12CA226330
Organisme : NIH HHS
ID : R01-CA250012
Pays : United States
Organisme : South African Medical Research Council
ID : MRC-RFA-SHIP 01-2019
Organisme : NCI NIH HHS
ID : R01 CA250012
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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