Association of Immunosuppression and Human Immunodeficiency Virus (HIV) Viremia with Anal Cancer Risk in Persons Living with HIV in the United States and Canada
- Hernandez-Ramirez, R.U.
- Qin, L.
- Lin, H.
- Leyden, W.
- Neugebauer, R.S.
- Althoff, K.N.
- Hessol, N.A.
- Achenbach, C.J.
- Brooks, J.T.
- Gill, M.J.
- Grover, S.
- Horberg, M.A.
- Li, J.
- Mathews, W.C.
- Mayor, A.M.
- Patel, P.
- Rabkin, C.S.
- Rachlis, A.
- Justice, A.C.
- Moore, R.D.
- Engels, E.A.
- Silverberg, M.J.
- Dubrow, R.
- Benson, C.A.
- Bosch, R.J.
- Kirk, G.D.
- Mayer, K.H.
- Grasso, C.
- Hogg, R.S.
- Richard Harrigan, P.
- Montaner, J.S.G.
- Yip, B.
- Zhu, J.
- Salters, K.
- Gabler, K.
- Buchacz, K.
- Gebo, K.A.
- Rodriguez, B.
- Thorne, J.E.
- Margolick, J.B.
- Jacobson, L.P.
- DSouza, G.
- Klein, M.B.
- Kroch, A.
- Burchell, A.
- Betts, A.
- Lindsay, J.
- Hunter-Mellado, R.F.
- John Gill, M.
- Deeks, S.G.
- Martin, J.N.
- Saag, M.S.
- Mugavero, M.J.
- Willig, J.
- Mathews, W.C.
- Eron, J.J.
- Napravnik, S.
- Kitahata, M.M.
- Crane, H.M.
- Drozd, D.R.
- Sterling, T.R.
- Haas, D.
- Rebeiro, P.
- Turner, M.
- Fiellin, D.
- Gange, S.J.
- Anastos, K.
- McKaig, R.G.
- Freeman, A.M.
- Van Rompaey, S.E.
- Morton, L.
- McReynolds, J.
- Lober, W.B.
- Lee, J.S.
- You, B.
- Hogan, B.
- Zhang, J.
- Jing, J.
- Humes, E.
- Coburn, S.
DOIAbstract
Background: People living with human immunodeficiency virus (HIV; PLWH) have a markedly elevated anal cancer risk, largely due to loss of immunoregulatory control of oncogenic human papillomavirus infection. To better understand anal cancer development and prevention, we determined whether recent, past, cumulative, or nadir/peak CD4+ T-cell count (CD4) and/or HIV-1 RNA level (HIV RNA) best predict anal cancer risk. Methods: We studied 102 777 PLWH during 1996-2014 from 21 cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. Using demographics-adjusted, cohort-stratified Cox models, we assessed associations between anal cancer risk and various time-updated CD4 and HIV RNA measures, including cumulativ...
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