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Home >> Publications >> Is nelfinavir exposure associated with cancer incidence in HIV-positive individuals?

Publication

Author(s):

Boettiger DC, Sabin CA, Grulich A, Ryom L, Bonnet F, Reiss P, Monforte AD, Kirk O, Phillips A, Bower M, Fätkenheuer G, Lundgren JD, Law M; Data collection on Adverse events of Anti-HIV Drugs (D:A:D) study group..

Pub Title:

Is nelfinavir exposure associated with cancer incidence in HIV-positive individuals?

Pub Date:

Feb 5 2016

Pub Region(s):

Asia-Pacific

Journal Issue:

online

Page Number:
online

Journal:

Title: 
AIDS
Link: 
http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=9000&issue=00000&article=97847&type=abstract

PubMed: 26854812
Abstract
OBJECTIVE:
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.
DESIGN:
Observational cohort study.
METHODS:
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.
RESULTS:
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).
CONCLUSIONS:
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.

 

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Citation:

Boettiger DC, Sabin CA, Grulich A, Ryom L, Bonnet F, Reiss P, Monforte AD, Kirk O, Phillips A, Bower M, et al. Is nelfinavir exposure associated with cancer incidence in HIV-positive individuals? AIDS. 2016 Feb 5. [Epub ahead of print] PubMed PMID: 26854812.