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

Publication

Author(s):

Boettiger DC1, 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:

Jun 20 2016

Pub Region(s):

Asia-Pacific

Journal:

Title: 
AIDS

PubMed: 26854812
Pub PDF:

OBJECTIVE: Nelfinavir exhibits potent anticancer properties against a range of tumours. However, in 2006/2007, 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 analysed using Poisson regression models to examine associations between cancer incidence and cumulative nelfinavir exposure, current nelfinavir exposure, and exposure to nelfinavir between 1 July 2006-30 June 2007.

RESULTS: A total of 42 006 individuals (50% white, 73% male) contributed 303 005 person-years of follow-up between 1 January 2004 and 1 February 2014. At study enrolment, median age was 40 [interquartile range (IQR) 33-46] years and 8305 individuals had a history of nelfinavir use [median duration 1.7 (IQR 0.7-3.4) years]. During follow-up, nelfinavir was used by 2476 individuals for a median of 1.7 (IQR 0.7-3.8) years; 1063 were exposed to nelfinavir between 1 July 2006 and 30 June 2007. Overall, 2279 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 July 2006 and 30 June 2007 compared to those receiving other treatment over this period was 1.07 (95% CI 0.78-1.46, P = 0.68).

CONCLUSION: Nelfinavir use was not associated with a lower cancer incidence than other protease inhibitor regimens. As of February 2014, exposure to the 2006/2007 contamination of nelfinavir does not appear to be associated with increased cancer incidence

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Citation:

AIDS. 2016 Jun 19;30(10):1629-37. doi: 10.1097/QAD.0000000000001053. Is nelfinavir exposure associated with cancer incidence in HIV-positive individuals? Boettiger DC1, 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.