{"doi":"10.1093/cid/ciaf248","title":"Risk of Cancer in People With HIV Experiencing Varying Degrees of Immune Recovery With Sustained Virological Suppression on Antiretroviral Treatment for More Than 2 Years: An International, Multicenter, Observational Cohort","abstract":"BACKGROUND: The impact of long-term virological suppression (VS) and CD4 count recovery on non-AIDS-defining cancers (NADCs) is unclear. We determined whether poor immune recovery was associated with incident cancer risk in people with human immunodeficiency virus (HIV) with VS. METHODS: Participants from the Data-Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) and International Cohort Consortium of Infectious Disease (RESPOND) collaborations in Europe and Australia who achieved ≥2 years of VS on antiretroviral therapy (ART) between December 1999 and December 2022 were included. Follow-up was from baseline (date of VS for 2 years) until the earliest of a first cancer event, virological failure, final follow-up, or administrative censoring date. Multivariable Poisson regression was used to assess associations between cancer incidence (overall, AIDS-defining cancer, NADC, infection-related cancer, infection-unrelated cancer) and time-updated CD4 count stratified by pre-ART nadir CD4 counts. RESULTS: Overall, 48 343 people with VS were included (median [interquartile range] baseline age, 43 years [37-50]; CD4 count, 540 cells/µL [380-730]; nadir CD4 count, 245 cells/µL [121-394]; 74% male). There were 1933 incident cancers (median follow-up, 6.2 years [2.9-9.5]; incidence rate [IR], 6.43; 95% confidence interval [CI]: 6.15-6.73/1000 person-years). Higher time-updated CD4 count was associated with a reduced risk of overall cancer (adjusted incidence rate ratio for time-updated CD4 count 350-499 cells/µL: 0.45 [95% CI: 0.39-0.51]; 500-749 cells/µL: 0.30 [95% CI: 0.27-0.34]; and ≥750 cells/µL: 0.26 [95% CI: 0.23-0.30] vs <350 cells/µL; P < .0001). There was a significant reduction in all cancer risk by higher time-updated CD4 count, regardless of nadir CD4 count, with higher pre-ART nadir CD4 count exhibiting lower risk. CONCLUSIONS: Despite VS on ART for more than 2 years, people with poorer immune recovery experienced a significantly higher incidence of cancer. This highlights the importance of early HIV diagnosis and ART initiation, and appropriate cancer screening strategies for those with poor immune recovery.","journal":"Clinical Infectious Diseases","year":2025,"id":516664,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8926,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":364591,"name":"Lene Ryom","orcid":"0000-0002-6436-6461","position":1,"is_corresponding":false},{"id":369298,"name":"Caroline Sabin","orcid":"0000-0001-5173-2760","position":2,"is_corresponding":false},{"id":428691,"name":"Lauren Greenberg","orcid":"0000-0003-0581-3636","position":3,"is_corresponding":false},{"id":459803,"name":"Matthias Cavassini","orcid":"0000-0003-0933-7833","position":4,"is_corresponding":false},{"id":1047728,"name":"Alexander Egle","orcid":"0000-0003-0648-4416","position":5,"is_corresponding":false},{"id":364609,"name":"Claudine Duvivier","orcid":"0000-0001-5696-4173","position":6,"is_corresponding":false},{"id":241754,"name":"Ferdinand W.N.M. Wit","orcid":"0000-0003-2066-8115","position":7,"is_corresponding":false},{"id":200816,"name":"Cristina Mussini","orcid":null,"position":8,"is_corresponding":false},{"id":364601,"name":"Antonella d’Arminio Monforte","orcid":"0000-0003-0073-1789","position":9,"is_corresponding":false},{"id":1381993,"name":"Antonella Castagna","orcid":"0000-0001-6481-4570","position":10,"is_corresponding":false},{"id":346878,"name":"José M. Miró","orcid":"0000-0001-8057-7755","position":11,"is_corresponding":false},{"id":12057,"name":"Marc van der Valk","orcid":"0000-0002-8290-6425","position":12,"is_corresponding":false},{"id":509582,"name":"Fabrice Bonnet","orcid":"0000-0001-5927-4178","position":13,"is_corresponding":false},{"id":364600,"name":"Christian Pradier","orcid":"0000-0002-0676-6379","position":14,"is_corresponding":false},{"id":1382469,"name":"Matthias Skocic","orcid":null,"position":15,"is_corresponding":false},{"id":1047730,"name":"Raimonda Matulionytė","orcid":"0000-0003-4791-3133","position":16,"is_corresponding":false},{"id":844662,"name":"Marcel Stoeckle","orcid":"0000-0002-0088-5078","position":17,"is_corresponding":false},{"id":883658,"name":"Nadine Jaschinski","orcid":"0000-0003-4847-2966","position":18,"is_corresponding":false},{"id":1381994,"name":"A Timiryasova","orcid":"0009-0008-7451-8116","position":19,"is_corresponding":false},{"id":1047731,"name":"Joan Tallada","orcid":"0000-0002-7655-9068","position":20,"is_corresponding":false},{"id":365639,"name":"Felipe Rogatto","orcid":null,"position":21,"is_corresponding":false},{"id":364607,"name":"Vani Vannappagari","orcid":"0000-0002-0157-9689","position":22,"is_corresponding":false},{"id":1061033,"name":"Lital Young","orcid":null,"position":23,"is_corresponding":false},{"id":12038,"name":"Jens Lundgren","orcid":"0000-0001-8901-7850","position":24,"is_corresponding":false},{"id":364615,"name":"Kathy Petoumenos","orcid":"0000-0001-7534-7154","position":25,"is_corresponding":false},{"id":12029,"name":"Jennifer Hoy","orcid":"0000-0002-6948-7086","position":26,"is_corresponding":false},{"id":634252,"name":"Win Min Han","orcid":"0000-0003-3731-7960","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T02:48:49.486328Z","pmid":"40368374","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}