Incidence of cancer and overall risk of mortality in individuals treated with raltegravir-based and non-raltegravir-based cART regimens. HIV Medicine
Cozzi-Lepri et al. on behalf of the EuroSIDA Study Group aimed to compare the incidences of malignancies and other comorbidities as well as survival rates in cohorts of individuals initiating raltegravir (RAL-) based and non-RAL-based combination antiretroviral therapy (cART) regimens in a large European cohort of HIV-infected patients. The cohort was divided into three groups: those starting RAL-based cART on or after 21 December 2007 (RAL); a historical cohort (HIST) of individuals adding a new antiretroviral (ARV) drug (not RAL) to their cART between 1 January 2005 and 20 December 2007, and a concurrent cohort (CONC) of individuals adding a new ARV drug (not RAL) to their cART on or after 21 December 2007.
A total of 1’470 patients were included in the RAL cohort, 3’787 patients were included in the HIST comparison cohort and 4’467 patients were included in the CONC cohort. The prevalence of non-AIDS-related malignancies prior to baseline tended to be higher in the RAL cohort vs. the HIST cohort [adjusted odds ratio (aOR) 1.31; and vs. the CONC cohort (aOR 1.89). In intention-to-treat (ITT) analysis the incidence of all new malignancies was 1.10 per 100 PYFU in the RAL cohort vs. 1.20 and 0.83 in the HIST and CONC cohorts, respectively. After adjustment, there was no evidence for a difference in the risk of malignancies or mortality.
In conclusion, the study-findings show that use of RAL does not seem to be associated with an increased risk of cancer or reduced survival when compared with the cancer and survival rates seen in people treated with alternative regimens in routine clinical care.