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HIV Patients with a CD4 Cell Count Below 500 Cells/mm3 Are at Increased Risk for Cancer

A CD4 cell count above 500 cells/mm3 protects HIV patients from developing either AIDS-defining or non-AIDS-defining cancers, according to results of a French study published in the October 8, 2009 issue of Lancet Oncology. Current CD4 cell count was the most predictive risk factor for all malignancies apart from anal cancer, noted the study authors.

The French researchers investigated the incidence of both AIDS-defining cancers (Kaposi's sarcoma, non-Hodgkin lymphoma, and cervical cancer) and non-AIDS-defining cancers (Hodgkin's lymphoma, lung cancer, liver cancer, and anal cancer) in 52 278 patients followed up in the French Hospital Database on HIV cohort during 1998-2006.

Most current HIV treatment guidelines recommend starting antiretroviral therapy (ART) in patients when their CD4 cell count is approximately 350 cells/mm3. "Our results suggest that ART would be most beneficial if it restores or maintains the CD4 cell count above 500 cells/mm3, thereby indicating earlier diagnosis of HIV infection and earlier treatment initiation", the authors wrote.

Link to the authors' summary.

10/09/09

Reference
M Guiguet, F Boué, J Cadranel, and others (on behalf of the Clinical Epidemiology Group of the FHDH-ANRS CO4 cohort). Effect of immunodeficiency, HIV viral load, and antiretroviral therapy on the risk of individual malignancies (FHDH-ANRS CO4): a prospective cohort study. The Lancet Oncology. Early Online Publication, 8 October 2009. doi:10.1016/S1470-2045(09)70282-7.