Is Nelfinavir Exposure Associated with Cancer Incidence in HIV-positive individuals?
Identifieur interne : 001C24 ( Main/Exploration ); précédent : 001C23; suivant : 001C25Is Nelfinavir Exposure Associated with Cancer Incidence in HIV-positive individuals?
Auteurs : David C. Boettiger [Australie] ; Caroline A. Sabin [Royaume-Uni] ; Andrew Grulich [Australie] ; Lene Ryom [Danemark] ; Fabrice Bonnet [France] ; Peter Reiss [Pays-Bas] ; Antonella D Rminio Monforte [Italie] ; Ole Kirk [Danemark] ; Andrew Phillips [Royaume-Uni] ; Mark Bower [Royaume-Uni] ; Gerd F Tkenheuer [Allemagne] ; Jens D. Lundgren [Danemark] ; Matthew Law [Australie]Source :
- AIDS (London, England) [ 0269-9370 ] ; 2016.
Abstract
Nelfinavir exhibits potent anti-cancer properties against a range of tumours. However, in 2006/07, nelfinavir supplies were accidently contaminated with a carcinogen. This analysis investigated the association between nelfinavir use and cancer risk in HIV-positive persons.
Observational cohort study.
D:A:D study data was analyzed using Poisson regression models to examine associations between cancer incidence and cumulative nelfinavir exposure, current nelfinavir exposure, and exposure to nelfinavir between 1/Jul/2006–30/Jun/2007.
A total of 42,006 individuals (50% white, 73% male) contributed 303,005 person-years of follow-up between 1/Jan/2004–1/Feb/2014. At study enrolment, median age was 40 (interquartile range [IQR] 33–46) years and 8,305 individuals had a history of nelfinavir use (median duration 1.7 [IQR 0.7–3.4] years). During follow-up, nelfinavir was used by 2,476 individuals for a median of 1.7 (IQR 0.7–3.8) years; 1,063 were exposed to nelfinavir between 1/Jul/2006–30/Jun/2007. Overall, 2,279 cancers were diagnosed at a rate of 0.75 (95% confidence interval [95%CI] 0.72–0.78) per 100 person-years. Neither greater cumulative exposure to nelfinavir (adjusted risk ratio [aRR] 0.93 for every additional 5 years, 95%CI 0.82–1.06, p=0.26) nor current use of nelfinavir (aRR 0.98 vs. other protease inhibitor use, 95%CI 0.68–1.41, p=0.92) were associated with cancer risk. The adjusted risk of cancer for participants exposed to nelfinavir between 1/Jul/2006–30/Jun/2007 compared to those receiving other treatment over this period was 1.07 (95%CI 0.78–1.46, p=0.68).
Nelfinavir use was not associated with a lower cancer incidence than other protease inhibitor regimens. As of Feb/2014, exposure to the 2006/07 contamination of nelfinavir does not appear to be associated with increased cancer incidence.
Url:
DOI: 10.1097/QAD.0000000000001053
PubMed: 26854812
PubMed Central: 4889546
Affiliations:
- Allemagne, Australie, Danemark, France, Italie, Pays-Bas, Royaume-Uni
- Angleterre, Aquitaine, District de Cologne, Grand Londres, Hollande-Septentrionale, Lombardie, Nouvelle-Aquitaine, Nouvelle-Galles du Sud, Rhénanie-du-Nord-Westphalie
- Amsterdam, Bordeaux, Cologne, Londres, Milan, Sydney
- Université d'Amsterdam, Université de Bordeaux
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University of Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen</wicri:regionArea><wicri:noRegion>Rigshospitalet - University of Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name><affiliation wicri:level="3"><nlm:aff id="A2">Research Department of Infection and Population Health, UCL, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research Department of Infection and Population Health, UCL, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bower, Mark" sort="Bower, Mark" uniqKey="Bower M" first="Mark" last="Bower">Mark Bower</name><affiliation wicri:level="3"><nlm:aff id="A7">National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="F Tkenheuer, Gerd" sort="F Tkenheuer, Gerd" uniqKey="F Tkenheuer G" first="Gerd" last="F Tkenheuer">Gerd F Tkenheuer</name><affiliation wicri:level="3"><nlm:aff id="A8">Leiter Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Köln, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leiter Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Köln</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Cologne</settlement></placeName></affiliation></author><author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D" last="Lundgren">Jens D. 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Boettiger</name><affiliation wicri:level="3"><nlm:aff id="A1">The Kirby Institute, UNSW Australia, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Kirby Institute, UNSW Australia, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A" last="Sabin">Caroline A. Sabin</name><affiliation wicri:level="3"><nlm:aff id="A2">Research Department of Infection and Population Health, UCL, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research Department of Infection and Population Health, UCL, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Grulich, Andrew" sort="Grulich, Andrew" uniqKey="Grulich A" first="Andrew" last="Grulich">Andrew Grulich</name><affiliation wicri:level="3"><nlm:aff id="A1">The Kirby Institute, UNSW Australia, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Kirby Institute, UNSW Australia, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name><affiliation wicri:level="1"><nlm:aff id="A3">CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen</wicri:regionArea><wicri:noRegion>Rigshospitalet - University of Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Bonnet, Fabrice" sort="Bonnet, Fabrice" uniqKey="Bonnet F" first="Fabrice" last="Bonnet">Fabrice Bonnet</name><affiliation wicri:level="4"><nlm:aff id="A4">CHU de Bordeaux and INSERM U897, Université de Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CHU de Bordeaux and INSERM U897, Université de Bordeaux</wicri:regionArea><wicri:noRegion>Université de Bordeaux</wicri:noRegion><placeName><settlement type="city">Bordeaux</settlement><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region></placeName><orgName type="university">Université de Bordeaux</orgName></affiliation></author><author><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name><affiliation wicri:level="4"><nlm:aff id="A5">Division of Infectious Diseases and Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Division of Infectious Diseases and Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="D Rminio Monforte, Antonella" sort="D Rminio Monforte, Antonella" uniqKey="D Rminio Monforte A" first="Antonella" last="D Rminio Monforte">Antonella D Rminio Monforte</name><affiliation wicri:level="3"><nlm:aff id="A6">Department of Health Sciences, San Paolo University Hospital, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Sciences, San Paolo University Hospital, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name><affiliation wicri:level="1"><nlm:aff id="A3">CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen</wicri:regionArea><wicri:noRegion>Rigshospitalet - University of Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name><affiliation wicri:level="3"><nlm:aff id="A2">Research Department of Infection and Population Health, UCL, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research Department of Infection and Population Health, UCL, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bower, Mark" sort="Bower, Mark" uniqKey="Bower M" first="Mark" last="Bower">Mark Bower</name><affiliation wicri:level="3"><nlm:aff id="A7">National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="F Tkenheuer, Gerd" sort="F Tkenheuer, Gerd" uniqKey="F Tkenheuer G" first="Gerd" last="F Tkenheuer">Gerd F Tkenheuer</name><affiliation wicri:level="3"><nlm:aff id="A8">Leiter Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Köln, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Leiter Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Köln</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Cologne</settlement></placeName></affiliation></author><author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D" last="Lundgren">Jens D. Lundgren</name><affiliation wicri:level="1"><nlm:aff id="A3">CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet - University of Copenhagen</wicri:regionArea><wicri:noRegion>Rigshospitalet - University of Copenhagen</wicri:noRegion></affiliation></author><author><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name><affiliation wicri:level="3"><nlm:aff id="A1">The Kirby Institute, UNSW Australia, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Kirby Institute, UNSW Australia, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author></analytic><series><title level="j">AIDS (London, England)</title><idno type="ISSN">0269-9370</idno><idno type="eISSN">1473-5571</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">Nelfinavir exhibits potent anti-cancer properties against a range of tumours. However, in 2006/07, nelfinavir supplies were accidently contaminated with a carcinogen. This analysis investigated the association between nelfinavir use and cancer risk in HIV-positive persons.</p></sec><sec id="S2"><title>Design</title><p id="P2">Observational cohort study.</p></sec><sec id="S3"><title>Methods</title><p id="P3">D:A:D study data was analyzed using Poisson regression models to examine associations between cancer incidence and cumulative nelfinavir exposure, current nelfinavir exposure, and exposure to nelfinavir between 1/Jul/2006–30/Jun/2007.</p></sec><sec id="S4"><title>Results</title><p id="P4">A total of 42,006 individuals (50% white, 73% male) contributed 303,005 person-years of follow-up between 1/Jan/2004–1/Feb/2014. At study enrolment, median age was 40 (interquartile range [IQR] 33–46) years and 8,305 individuals had a history of nelfinavir use (median duration 1.7 [IQR 0.7–3.4] years). During follow-up, nelfinavir was used by 2,476 individuals for a median of 1.7 (IQR 0.7–3.8) years; 1,063 were exposed to nelfinavir between 1/Jul/2006–30/Jun/2007. Overall, 2,279 cancers were diagnosed at a rate of 0.75 (95% confidence interval [95%CI] 0.72–0.78) per 100 person-years. Neither greater cumulative exposure to nelfinavir (adjusted risk ratio [aRR] 0.93 for every additional 5 years, 95%CI 0.82–1.06, p=0.26) nor current use of nelfinavir (aRR 0.98 vs. other protease inhibitor use, 95%CI 0.68–1.41, p=0.92) were associated with cancer risk. The adjusted risk of cancer for participants exposed to nelfinavir between 1/Jul/2006–30/Jun/2007 compared to those receiving other treatment over this period was 1.07 (95%CI 0.78–1.46, p=0.68).</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Nelfinavir use was not associated with a lower cancer incidence than other protease inhibitor regimens. As of Feb/2014, exposure to the 2006/07 contamination of nelfinavir does not appear to be associated with increased cancer incidence.</p></sec></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Danemark</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Aquitaine</li><li>District de Cologne</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Lombardie</li><li>Nouvelle-Aquitaine</li><li>Nouvelle-Galles du Sud</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Amsterdam</li><li>Bordeaux</li><li>Cologne</li><li>Londres</li><li>Milan</li><li>Sydney</li></settlement><orgName><li>Université d'Amsterdam</li><li>Université de Bordeaux</li></orgName></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Boettiger, David C" sort="Boettiger, David C" uniqKey="Boettiger D" first="David C" last="Boettiger">David C. Boettiger</name></region><name sortKey="Grulich, Andrew" sort="Grulich, Andrew" uniqKey="Grulich A" first="Andrew" last="Grulich">Andrew Grulich</name><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A" last="Sabin">Caroline A. Sabin</name></region><name sortKey="Bower, Mark" sort="Bower, Mark" uniqKey="Bower M" first="Mark" last="Bower">Mark Bower</name><name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name></country><country name="Danemark"><noRegion><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name></noRegion><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D" last="Lundgren">Jens D. Lundgren</name></country><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Bonnet, Fabrice" sort="Bonnet, Fabrice" uniqKey="Bonnet F" first="Fabrice" last="Bonnet">Fabrice Bonnet</name></region></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name></region></country><country name="Italie"><region name="Lombardie"><name sortKey="D Rminio Monforte, Antonella" sort="D Rminio Monforte, Antonella" uniqKey="D Rminio Monforte A" first="Antonella" last="D Rminio Monforte">Antonella D Rminio Monforte</name></region></country><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="F Tkenheuer, Gerd" sort="F Tkenheuer, Gerd" uniqKey="F Tkenheuer G" first="Gerd" last="F Tkenheuer">Gerd F Tkenheuer</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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