4.4 Article

Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis

Journal

AIDS
Volume 30, Issue 2, Pages 273-291

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000000922

Keywords

acquired immunodeficiency syndrome; cancer prevention; cancer risk factors; high-income countries; HIV infections; neoplasms

Funding

  1. National Institute of Mental Health [5T32-MH020031, P30-MH062294]
  2. National Institute on Alcohol Abuse and Alcoholism [1U01-AA020790]
  3. National Cancer Institute [R01-CA165937, F31-CA180775, R01-CA173754]
  4. National Institute of Allergy and Infectious Diseases [K01-AI071725]
  5. National Institute of Diabetes and Digestive and Kidney Diseases [3T32-DK007217]

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Objective:The burden of cancer among persons living with HIV/AIDS (PLWHA) is substantial and increasing. We assessed the prevalence of modifiable cancer risk factors among adult PLWHA in Western high-income countries since 2000.Design:Meta-analysis.Methods:We searched PubMed to identify articles published in 2011-2013 reporting prevalence of smoking, alcohol consumption, overweight/obesity, and infection with human papillomavirus (HPV), hepatitis C virus (HCV) and hepatitis B virus (HBV) among PLWHA. We conducted random effects meta-analyses of prevalence for each risk factor, including estimation of overall, sex-specific, and HIV-transmission-group-specific prevalence. We compared prevalence in PLWHA with published prevalence estimates in US adults.Results:The meta-analysis included 113 publications. Overall summary prevalence estimates were current smoking, 54% [95% confidence interval (CI) 49-59%] versus 20-23% in US adults; cervical high-risk HPV infection, 46% (95% CI 34-58%) versus 29% in US females; oral high-risk HPV infection, 16% (95% CI 10-23%) versus 4% in US adults; anal high-risk HPV infection (men who have sex with men), 68% (95% CI 57-79%), with no comparison estimate available; chronic HCV infection, 26% (95% CI 21-30%) versus 0.9% in US adults; and HBV infection, 5% (95% CI 4-5%) versus 0.3% in US adults. Overweight/obesity prevalence (53%; 95% CI 46-59%) was below that of US adults (68%). Meta-analysis of alcohol consumption prevalence was impeded by varying assessment methods. Overall, we observed considerable study heterogeneity in prevalence estimates.Conclusion:Prevalence of smoking and oncogenic virus infections continues to be extraordinarily high among PLWHA, indicating a vital need for risk factor reduction efforts.

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