Observational studyJournal of acquired immune deficiency syndromes (1999)2026
Incidence of AIDS-Defining Illness by Cancer Status in an Observational Study Among Medicaid Beneficiaries Living With HIV in the United States, 2001-2015.
Observational study in Journal of acquired immune deficiency syndromes (1999), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Differences in utilization, complications, and mortality after cancer surgery by HIV status among Medicaid beneficiaries from 2001-2021.medRxiv : the preprint server for health sciences · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundMalignant neoplasms remain one of the leading morbidities and causes of death among people with HIV (PWH). Prior research suggests that certain cancer treatments may have deleterious effects on the immune system.
settingWe quantified the relationship between non-AIDS-defining cancers (NADC) and the development of a new AIDS-defining illness (ADI) among PWH in Medicaid. We assembled a cohort of 154,493 Medicaid beneficiaries aged 18-64 years with HIV from 14 US States between 2001 and 2015, with no evidence of a prevalent ADI or cancer.
methodsWe estimated incidence rates of first ADI among PWH who did and did not develop NADC. NADC status was time updated, allowing individuals to contribute person-time before and after cancer diagnosis. We compared rates across NADC status by estimating adjusted incidence rate ratios using Poisson regression, controlling for sex, race/ethnicity, age, calendar year, and US state.
resultsPWH contributed 409,157 person-years, 3843 incident NADCs, and 28,875 ADIs, resulting in an overall incidence rate of 7.06 ADIs per 100 person-years (among those without cancer: 6.9, 95% confidence interval (CI): 6.82 to 6.98; after cancer diagnosis: 15.52, 95% CI: 14.66 to 16.43). The adjusted incidence rate ratio of ADIs after cancer diagnosis was elevated for all NADCs (2.82, 95% CI: 2.63 to 3.02) and specific cancers (lung, colon, breast, and prostate).
conclusionsIncidence of new ADIs was elevated after cancer diagnosis. PWH undergoing cancer treatment may require careful observation for ADI development and potentially warrant consideration of immune-sparing cancer treatment regimens given prior data suggesting sustained decreases in CD4 cell counts after cancer treatment.
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