1
|
Bowsher R, Marczylo TH, Gooch K, Bailey A, Wright MD, Marczylo EL. Smoking and vaping alter genes related to mechanisms of SARS-CoV-2 susceptibility and severity: a systematic review and meta-analysis. Eur Respir J 2024; 64:2400133. [PMID: 38991709 PMCID: PMC11269771 DOI: 10.1183/13993003.00133-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/23/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Evidence for the impact of smoking on coronavirus disease 2019 (COVID-19) is contradictory, and there is little research on vaping. Here we provide greater clarity on mechanisms perturbed by tobacco cigarette, electronic cigarette and nicotine exposures that may impact the risks of infection and/or disease severity. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the Ovid and Web of Science databases were searched. Study design and exposure-induced gene expression changes were extracted. Each study was quality assessed and higher confidence scores were assigned to genes consistently changed across multiple studies following the same exposure. These genes were used to explore pathways significantly altered following exposure. RESULTS 125 studies provided data on 480 genes altered by exposure to tobacco cigarettes, e-cigarettes, nicotine or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Genes involved in both SARS-CoV-2 viral-entry and inflammation were changed following exposure. Pathway analysis revealed that many of those genes with high confidence scores are involved in common cellular processes relating to hyperinflammatory immune responses. CONCLUSION Exposure to tobacco cigarettes, e-cigarettes or nicotine may therefore impact initial host-pathogen interactions and disease severity. Smokers and vapers of e-cigarettes with nicotine could potentially be at increased risk of SARS-CoV-2 infection, associated cytokine storm, and acute respiratory distress syndrome. However, further research is required, particularly on e-cigarettes, to determine the biological mechanisms involved in perturbation of viral-entry genes and host-pathogen interactions and subsequent responses within the respiratory tract. This will improve our physiological understanding of the impact of smoking and vaping on COVID-19, informing public health advice and providing improved guidance for management of SARS-CoV-2 and other respiratory viruses.
Collapse
Affiliation(s)
- Rachel Bowsher
- Toxicology Department, UK Health Security Agency, Chilton, UK
- Pharmacology Section, St George's University of London, London, UK
| | | | - Karen Gooch
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Salisbury, UK
| | - Alexis Bailey
- Pharmacology Section, St George's University of London, London, UK
| | | | - Emma L Marczylo
- Toxicology Department, UK Health Security Agency, Chilton, UK
| |
Collapse
|
2
|
Wang H, Guo C, Zhang X, Xu Y, Li Y, Wang T, Liu Z, Zhu X, Zhang T. Prognostic factors for competing risk in patients with AIDS-related Kaposi's sarcoma: A SEER population-based study. HIV Med 2024; 25:60-71. [PMID: 37574804 DOI: 10.1111/hiv.13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Despite the improved survival of patients with AIDS and Kaposi's sarcoma (KS), competing events are a non-negligible issue affecting the survival of such patients. In this study, we explored the prognostic factors of KS-specific and non-KS-specific mortality in patients with AIDS-related KS (AIDS-KS), accounting for competing risk. METHODS We identified 17 103 patients with AIDS-KS aged 18-65 years between 1980 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) 18 registry database. Prognostic factors for KS-specific and non-KS-specific mortality were determined by the Fine and Grey proportional subdistribution hazard model. We built competing risk nomograms and assessed their predictive performance based on the identified prognostic factors. RESULTS In total, 12 943 (75.68%) patients died, 1965 (15.50%) of whom died from competing events. The KS-specific mortality rate was 14 835 per 100 000 person-years, and the non-KS specific mortality rate was 2719 per 100 000 person-years. Specifically, age >44 years was associated with an 11% decrease in the subdistribution hazard of KS-specific mortality compared with age <43 years but a 50% increase in the subdistribution hazard of non-KS-specific mortality. Being male was associated with a 26% increase in the subdistribution hazard of KS-specific mortality compared with being female but a 32% decrease in the subdistribution hazard of non-KS-specific mortality. Notably, being in the antiretroviral therapy (ART) era consistently showed a decrease in the subdistribution hazard of both KS-specific and non-KS-specific mortality than being in the pre-ART era. CONCLUSIONS Competing events commonly occurred among patients with AIDS-KS, which deserves further attention to improve the prognosis of these patients.
Collapse
Affiliation(s)
- Haili Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Chengnan Guo
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Xin Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yiyun Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yi Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Tianye Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Xiaohua Zhu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Yiwu Research Institue, Fudan University, Yiwu, China
| |
Collapse
|
3
|
Rusu-Zota G, Manole OM, Galeș C, Porumb-Andrese E, Obadă O, Mocanu CV. Kaposi Sarcoma, a Trifecta of Pathogenic Mechanisms. Diagnostics (Basel) 2022; 12:1242. [PMID: 35626397 PMCID: PMC9140574 DOI: 10.3390/diagnostics12051242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 01/10/2023] Open
Abstract
Kaposi's sarcoma is a rare disease with four known variants: classic, epidemic, endemic and iatrogenic (transplant-related), all caused by an oncogenic virus named Human Herpes Virus 8. The viral infection in itself, along with the oncogenic properties of HHV8 and with immune system dysfunction, forms the grounds on which Kaposi's Sarcoma may develop. Infection with HHV8 occurs through saliva via close contacts, blood, blood products, solid organ donation and, rarely, vertical transmission. Chronic inflammation and oncogenesis are promoted by a mix of viral genes that directly promote cell survival and transformation or interfere with the regular cell cycle and cell signaling (of particular note: LANA-1, v-IL6, vBCL-2, vIAP, vIRF3, vGPCR, gB, K1, K8.1, K15). The most common development sites for Kaposi's sarcoma are the skin, mucocutaneous zones, lymph nodes and visceral organs, but it can also rarely appear in the musculoskeletal system, urinary system, endocrine organs, heart or eye. Histopathologically, spindle cell proliferation with slit-like vascular spaces, plasma cell and lymphocyte infiltrate are characteristic. The clinical presentation is heterogenic depending on the variant; some patients have indolent disease and others have aggressive disease. The treatment options include highly active antiretroviral therapy, surgery, radiation therapy, chemotherapy, and immunotherapy. A literature search was carried out using the MEDLINE/PubMed, SCOPUS and Google Scholar databases with a combination of keywords with the aim to provide critical, concise, and comprehensive insights into advances in the pathogenic mechanism of Kaposi's sarcoma.
Collapse
Affiliation(s)
- Gabriela Rusu-Zota
- Department of Pharmacology, Clinical Pharmacology and Algesiology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| | - Oana Mădălina Manole
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania
| | - Cristina Galeș
- Department of Histology, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| | - Elena Porumb-Andrese
- Department of Dermatology, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| | - Otilia Obadă
- Department of Ophthalmology, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| | - Cezar Valentin Mocanu
- Department of Anatomical Pathology, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| |
Collapse
|
4
|
Ding M, Wu J, Sun R, Yan L, Bai L, Shi J, Feng H, Zhang Y, Lan K, Wang X. Androgen receptor transactivates KSHV noncoding RNA PAN to promote lytic replication-mediated oncogenesis: A mechanism of sex disparity in KS. PLoS Pathog 2021; 17:e1009947. [PMID: 34543357 PMCID: PMC8483343 DOI: 10.1371/journal.ppat.1009947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/30/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023] Open
Abstract
Kaposi’s sarcoma-associated herpesvirus (KSHV) preferentially infects and causes Kaposi’s sarcoma (KS) in male patients. However, the biological mechanisms are largely unknown. This study was novel in confirming the extensive nuclear distribution of the androgen receptor (AR) and its co-localization with viral oncoprotein of latency-associated nuclear antigen in KS lesions, indicating a transcription way of AR in KS pathogenesis. The endogenous AR was also remarkably higher in KSHV-positive B cells than in KSHV-negative cells and responded to the ligand treatment of 5α-dihydrotestosterone (DHT), the agonist of AR. Then, the anti-AR antibody-based chromatin immunoprecipitation (ChIP)-associated sequencing was used to identify the target viral genes of AR, revealing that the AR bound to multiple regions of lytic genes in the KSHV genome. The highest peak was enriched in the core promoter sequence of polyadenylated nuclear RNA (PAN), and the physical interaction was verified by ChIP–polymerase chain reaction (PCR) and the electrophoretic mobility shift assay (EMSA). Consistently, male steroid treatment significantly transactivated the promoter activity of PAN in luciferase reporter assay, consequently leading to extensive lytic gene expression and KSHV production as determined by real-time quantitative PCR, and the deletion of nuclear localization signals of AR resulted in the loss of nuclear transport and transcriptional activity in the presence of androgen and thus impaired the expression of PAN RNA. Oncogenically, this study identified that the AR was a functional prerequisite for cell invasion, especially under the context of KSHV reactivation, through hijacking the PAN as a critical effector. Taken together, a novel mechanism from male sex steroids to viral noncoding RNA was identified, which might provide a clue to understanding the male propensity in KS. Although the incidence of Kaposi’ sarcoma (KS) is higher in men, little is known about the mechanisms by which male sex steroids contribute to this disparity. The present study confirmed the striking expression of the androgen receptor (AR) and its concordant nuclear distribution in KS tissues. High-throughput chromatin immunoprecipitation sequencing analysis showed that the AR had extensive binding sites in the KSHV genome, in which the highest enriched gene was PAN. PAN also exhibited the strongest upregulation of promoter activity and RNA transcription among various KSHV lytic genes after the male hormone treatment. Specifically, the effect was a result of the DNA-binding capability of AR to PAN promoter. Moreover, the AR induced dramatic cell invasion, especially under KSHV lytic replication, and the effect was greatly impaired by the inhibitory effect of siRNA on PAN RNA. This study provided a unique insight into the reason why KS occurred predominantly in men.
Collapse
Affiliation(s)
- Mingzhu Ding
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China
| | - Jinfeng Wu
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China
| | - Rui Sun
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, P.R. China
| | - Lijun Yan
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, P.R. China
| | - Lei Bai
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, P.R. China
| | - Jiajian Shi
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China
| | - Hua Feng
- Omics Core, Bio-Med Big Data Center, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, P.R. China
| | - Yuqi Zhang
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China
| | - Ke Lan
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, P.R. China
- * E-mail: (KL); (XW)
| | - Xing Wang
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China
- * E-mail: (KL); (XW)
| |
Collapse
|
5
|
Ngalamika O, Munsaka S, Lidenge SJ, West JT, Wood C. Antiretroviral Therapy for HIV-Associated Cutaneous Kaposi's Sarcoma: Clinical, HIV-Related, and Sociodemographic Predictors of Outcome. AIDS Res Hum Retroviruses 2021; 37:368-372. [PMID: 33386064 PMCID: PMC8112720 DOI: 10.1089/aid.2020.0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Kaposi's sarcoma (KS) is an AIDS-defining malignancy that can improve or worsen with antiretroviral therapy (ART). We aimed at identifying clinical, HIV-related, and sociodemographic factors associated with either progression or nonprogression (regression or stable disease) of ART-treated HIV-associated KS in patients with limited cutaneous disease. We conducted a prospective cohort study of ART-treated HIV-associated KS cases. Clinical, HIV-related, and sociodemographic variables were collected at baseline, and patients were followed up to determine treatment outcomes. Cox regression, linear mixed effects model, and Spearman's rank correlation were used for analysis. Half (50%) of the study participants had KS regression or stable disease, whereas the other half (50%) had disease progression during the treatment and follow-up period. Among the data analyzed, presence of KS nodules at baseline (hazard ratio = 5.47; 95% confidence interval = 1.32-22.65; p = .02) was an independent predictor of poor treatment outcome. Progressors and nonprogressors were indistinguishable in the changes they experienced in the HIV plasma viral load and CD4 counts as a result of ART. Even when cutaneous presentation is limited, the presence of nodular morphotype KS lesions should be considered an indicator for combined ART plus chemotherapy. Temporal trends in CD4 counts and HIV viral loads did not correlate with treatment outcome in ART-treated HIV-associated KS.
Collapse
Affiliation(s)
- Owen Ngalamika
- Dermatology and Venereology Section, Adult Hospital of the University Teaching Hospitals, University of Zambia School of Medicine, Lusaka, Zambia
| | - Sody Munsaka
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Salum J. Lidenge
- Ocean Road Cancer Institute, Academic and Research Unit, Dar es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Clinical Oncology Department, Dar es Salaam, Tanzania
- Nebraska Center for Virology, Lincoln, Nebraska, USA
- School of Biological Sciences, and University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - John T. West
- Nebraska Center for Virology, Lincoln, Nebraska, USA
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Charles Wood
- Nebraska Center for Virology, Lincoln, Nebraska, USA
- School of Biological Sciences, and University of Nebraska-Lincoln, Lincoln, Nebraska, USA
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| |
Collapse
|
6
|
Castilho JL, Kim A, Jenkins CA, Grinsztejn B, Gotuzzo E, Fink V, Padgett D, Belaunzaran‐Zamudio PF, Crabtree‐Ramírez B, Escuder MM, Souza RA, Tenore SB, Pimentel SR, Ikeda MLR, de Alencastro PR, Tupinanbas U, Brites C, Luz E, Netto J, Cortes CP, Grangeiro A, Shepherd BE, McGowan CC. Antiretroviral therapy and Kaposi's sarcoma trends and outcomes among adults with HIV in Latin America. J Int AIDS Soc 2021; 24:e25658. [PMID: 33405281 PMCID: PMC7787071 DOI: 10.1002/jia2.25658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Kaposi's sarcoma (KS) remains the most frequent malignancy in persons living with HIV (PWH) in Latin America. We examined KS trends and outcomes from Latin American clinical sites in the era of increased access to antiretroviral therapy (ART). METHODS Cohorts in Brazil, Peru, Mexico, Honduras, Argentina and Chile contributed clinical data of PWH ≥16 years old from 2000 to 2017, excluding patients with KS diagnosed before clinic enrolment. We compared KS incidence over time using multivariable incidence rate ratios. Predictors of KS before/at or after ART initiation and of mortality after KS were examined using Cox regression. RESULTS Of 25 981 PWH, 481 had incident KS, including 200 ART-naïve and 281 ART-treated patients. From 2000 to 2017, the incidence of KS decreased from 55.1 to 3.0 per 1000 person-years. In models adjusting for CD4 and other factors, the relative risk for KS decreased from 2000 to 2008. Since 2010, the adjusted risk of KS increased in the periods before and ≤90 days after ART initiation but decreased >90 days after ART. In addition to low CD4 and male-to-male sex, KS risk after ART was associated with age and history of other AIDS-defining illnesses. Mortality after KS (approximately 25% after five years) was not associated with either year of KS diagnosis nor timing of diagnosis relative to ART initiation. CONCLUSIONS KS incidence in Latin America has remained stable in recent years and risk is highest before and shortly after ART initiation. Early diagnosis of HIV and ART initiation remain critical priorities in the region.
Collapse
Affiliation(s)
- Jessica L Castilho
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Ahra Kim
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | - Cathy A Jenkins
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | | | - Eduardo Gotuzzo
- Universidad Peruana Cayetano HerediaInstituto de Medicina Tropical Alexander von HumboldtLimaPeru
| | - Valeria Fink
- Fundación HuéspedInvestigaciones ClínicasBuenos AiresArgentina
| | - Denis Padgett
- Instituto Hondureño de Seguridad Social and Hospital Escuela UniversitarioTegucigalpaHonduras
| | - Pablo F Belaunzaran‐Zamudio
- Deparatmento de InfectologiaInstituto Nacional de Ciencias Médicas y NutriciónSalvador Zubirán. Mexico CityMexico
| | - Brenda Crabtree‐Ramírez
- Deparatmento de InfectologiaInstituto Nacional de Ciencias Médicas y NutriciónSalvador Zubirán. Mexico CityMexico
| | | | - Rosa Alencar Souza
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Simone B Tenore
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Sidnei R Pimentel
- São Paulo State Department of HealthAIDS Reference and Training CenterSão PauloBrazil
| | - Maria Letícia Rodrigues Ikeda
- Care and Treatment Clinic of the Partenon SanatoriumRio Grande do Sul State Department of HealthPorto AlegreBrazil
- University of Vale do Rio dos SinosSão LeopoldoBrazil
| | - Paulo R de Alencastro
- Care and Treatment Clinic of the Partenon SanatoriumRio Grande do Sul State Department of HealthPorto AlegreBrazil
| | - Unai Tupinanbas
- Medical SchoolFederal University of Minas GeraisBelo HorizonteBrazil
| | - Carlos Brites
- Edgar Santos University Hospital ComplexFederal University of BahiaSalvadorBrazil
| | - Estela Luz
- Edgar Santos University Hospital ComplexFederal University of BahiaSalvadorBrazil
| | - Juliana Netto
- Instituto Nacional de Infectiologia Evandro ChagasFiocruzBrazil
| | - Claudia P Cortes
- Fundaciòn Arriaran and University of Chile School of MedicineSantiagoChile
| | - Alexandre Grangeiro
- Department of Preventive MedicineUniversity of São Paulo School of MedicineSão PauloBrazil
| | - Bryan E Shepherd
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | - Catherine C McGowan
- Division of Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | | |
Collapse
|
7
|
The pattern of secondary cancers in patients with Kaposi sarcoma in the United States. Cancer Causes Control 2017; 28:1065-1074. [PMID: 28900786 DOI: 10.1007/s10552-017-0957-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 09/07/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE In the U.S., Kaposi sarcoma (KS) occurs mostly in HIV-infected patients, who are also at increased risk of developing secondary cancers. The trends in secondary cancer risk are unclear in the HAART era. METHODS We extracted data from the SEER database on patients diagnosed with KS between 1981 and 2013, stratified into the pre-HAART (1981-1995) and HAART (1996-2013) eras. We compared the risk of secondary cancer in KS patients and the general population, and estimated the absolute risk. RESULTS We followed 13,535 KS patients for 49,813 person-years, during which 1,041 secondary cancers were diagnosed: 774 in the pre-HAART and 267 in the HAART era. In the pre-HAART era, non-Hodgkin's lymphoma (NHL) and anal carcinomas were the most common secondary cancers. The standard incidence ratio of secondary cancers decreased from 3.44 (pre-HAART era) to 1.94 (HAART era) in patients aged <70 years. The absolute excess risk decreased from 178 to 68 cases per 10,000 person-years. The risk of NHL decreased, while the risk of anal carcinoma did not change significantly. The risk of lung cancer was lower in KS patients than in the general population. The absolute risk of non-AIDS-defining cancers increased fourfold in the HAART era. CONCLUSIONS The absolute risk of non-AIDS-defining secondary cancers has increased in KS patients in the HAART era. However, the overall relative risk of secondary cancers has decreased, mainly due to a significant decrease in the risk of NHL.
Collapse
|
8
|
Squillace N, Galli L, Bandera A, Castagna A, Madeddu G, Caramello P, Antinori A, Cattelan A, Maggiolo F, Cingolani A, Gori A, Monforte AD. High-density lipoprotein-cholesterol levels and risk of cancer in HIV-infected subjects: Data from the ICONA Foundation Cohort. Medicine (Baltimore) 2016; 95:e4434. [PMID: 27603338 PMCID: PMC5023860 DOI: 10.1097/md.0000000000004434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Investigation of the relationship between high-density lipoprotein-cholesterol (HDL-c) and the risk of developing cancer in a prospective cohort of human immunodeficiency virus (HIV)-infected patients.The Italian Cohort of Antiretroviral-naïve Patients Foundation Cohort is an Italian multicenter observational study recruiting HIV-positive patients while still antiretroviral treatment-naïve, regardless of the reason since 1997.Patients with at least 1 HDL-c value per year since enrollment and one such value before antiretroviral treatment initiation were included. HDL-c values were categorized as either low (<39 mg/dL in males or <49 mg/dL in females) or normal. Cancer diagnoses were classified as AIDS-defining malignancies (ADMs) or non-AIDS-defining malignancies (NADMs). Kaplan-Meier curves and Cox proportional-hazards regression models were used.Among 4897 patients (13,440 person-years of follow-up [PYFU]), 104 diagnoses of cancer were observed (56 ADMs, 48 NADMs) for an overall incidence rate of 7.7 (95% confidence interval [CI] 6.3-9.2) per 1000 PYFU.Low HDL-c values at enrollment were associated with higher risk both of cancer (crude hazard ratio [HR] 1.72, 95% CI 1.16-2.56, P = 0.007) and of NADM (crude HR 2.50, 95% CI 1.35-4.76, P = 0.003). Multivariate analysis showed that the risk of cancer diagnosis was higher in patients with low HDL-c values (adjusted HR [AHR] 1.87, 95% CI 1.18-2.95, P = 0.007) in older patients, those patients more recently enrolled, and in those with low current cluster of differentiation 4+ levels, and/or high current HIV-ribonucleic acid.The multivariate model confirmed an association between HDL-c (AHR 2.61, 95% CI 1.40-4.89, P = 0.003) and risk of NADM.Low HDL-c is an independent predictor of cancer in HIV-1-infected subjects.
Collapse
Affiliation(s)
- Nicola Squillace
- Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza
| | - Laura Galli
- Infectious Diseases Department, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan
| | - Alessandra Bandera
- Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza
| | - Antonella Castagna
- Infectious Diseases Department, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Sassari, Sassari
| | - Pietro Caramello
- Infectious and Tropical Diseases Unit I, Department of Infectious Diseases, Amedeo di Savoia Hospital, Torino
| | - Andrea Antinori
- Clinical Department, National Institute of Infectious Diseases ‘L.Spallanzani’, Rome
| | | | - Franco Maggiolo
- Division of Infectious Diseases, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo
| | - Antonella Cingolani
- Department of Publich Health, Infectious Diseases, Catholic University, Rome
| | - Andrea Gori
- Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza
| | - Antonella d’Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases, ‘San Paolo’ Hospital, University of Milan, Milan, Italy
| |
Collapse
|
9
|
Kariuki W, Manuel JI, Kariuki N, Tuchman E, O'Neal J, Lalanne GA. HIV and smoking: associated risks and prevention strategies. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2015; 8:17-36. [PMID: 26766919 PMCID: PMC4700813 DOI: 10.2147/hiv.s56952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
High rates of smoking among persons living with HIV (PLWH) may reduce the effectiveness of HIV treatment and contribute to significant morbidity and mortality. Factors associated with smoking in PLWH include mental health comorbidity, alcohol and drug use, health-related quality of life, smoking among social networks and supports, and lack of access to care. PLWH smokers are at a higher risk of numerous HIV-associated infections and non-HIV related morbidity, including a decreased response to antiretroviral treatment, impaired immune functioning, reduced cognitive functioning, decreased lung functioning, and cardiovascular disease. Seventeen smoking cessation interventions were identified, of which seven were randomized controlled trials. The most effective studies combined behavioral and pharmacotherapy treatments that incorporated comprehensive assessments, multiple sessions, and cognitive-behavioral and motivational strategies. Smoking cessation interventions that are tailored to the unique needs of diverse samples and incorporate strategies to reduce the risk of relapse are essential to advancing health outcomes in PLWH.
Collapse
Affiliation(s)
- Wanjiku Kariuki
- University of Texas School of Public Health, Department of Management, Policy, and Community Health, Houston, TX, USA
| | | | - Ngaruiya Kariuki
- Internal Medicine Department, Maimonides Medical Center, Brooklyn, USA
| | - Ellen Tuchman
- Silver School of Social Work, New York University, New York, USA
| | - Johnnie O'Neal
- Department of Social Work, The College of New Rochelle, New Rochelle, NY, USA
| | | |
Collapse
|
10
|
McDonald AC, Jenkins FJ, Bunker CH, Wilson JW, Patrick AL, Weissfeld JL. Human herpesvirus 8 seroconversion in a population-based cohort of men in Tobago. J Med Virol 2015; 87:642-7. [PMID: 25612304 DOI: 10.1002/jmv.24128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 12/31/2022]
Abstract
Human herpesvirus 8 (HHV-8) is the causal agent of Kaposi's sarcoma (KS). In Tobago, KS is not common; however, HHV-8 seropositivity has been reported to be 39.9% in men with prostate cancer compared to <22.9% in healthier women and men. To understand HHV-8 transmission, we examined HHV-8 seroconversion and seroreversion, and risk factors for these changes in Tobago men. Serum specimens from a sub-cohort of Tobago Prostate Survey men, aged 40-81 years (n = 381/442), were collected at baseline and a subsequent visit between 3 and 9 years and tested for HHV-8 seropositivity using an immunofluorescence assay for antibodies against HHV-8 lytic antigens. Poisson distribution was used to calculate HHV-8 seroconversion and seroreversion rates and their 95% confidence intervals. Differences in baseline characteristics between HHV-seroconverters versus persistent HHV-8 seronegative men and HHV-8 seroreverters versus HHV-8 seropositive men were examined. HHV-8 seropositivity was 12.3% (N = 381) at baseline, with HHV-8 seropositivity significantly higher in increasing age groups, 40-49 (4.0%) to 70-81 (37.5%) years (P-value trend <0.0001). HHV-8 seroconversion and seroreversion rates were 0.23 per 100 person-years (95% C.I., 0.06-0.58) and 2.42 per 100 person-years (95% C.I., 0.89-5.26), respectively. There were significantly more HHV-8 seroconverters who reported "ever smoked cigarettes of >6 months" at baseline compared to HHV-8 persistent seronegative men (P-value = 0.03). Baseline characteristics of HHV-8 seroreverters did not differ from persistent seropositive men. Low HHV-8 seroconversion and seroreversion rates were found. Data suggest that HHV-8 transmission occurred at earlier ages, <40 years, in Tobago men.
Collapse
Affiliation(s)
- Alicia C McDonald
- Department of Population Health, Hofstra North Shore Long Island Jewish School of Medicine, Great Neck, New York; Feinstein Institute for Medical Research, North Shore Long Island Jewish Health System, Manhasset, New York
| | | | | | | | | | | |
Collapse
|