{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:24:40Z","timestamp":1781166280992,"version":"3.54.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01AI069924"],"award-info":[{"award-number":["U01AI069924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["320030_169967"],"award-info":[{"award-number":["320030_169967"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"U.S. CRDF Global","award":["HIV_DAA3-16-62705-1"],"award-info":[{"award-number":["HIV_DAA3-16-62705-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Most research on human immunodeficiency virus-1 (HIV-1) viremia and cancer risk is from high-income countries. We evaluated the association between HIV-1 viremia and the risk of various cancer types among people with HIV (PWH) in South Africa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed data from the South African HIV Cancer Match study, based on laboratory measurements from the National Health Laboratory Service and cancer records from the National Cancer Registry from 2004 to 2014. Using Cox proportional hazards models, we estimated hazard ratios (HR) for cancer incidence per unit increase in time-updated Log10 HIV-1 RNA viral load copies\/mL. We created partially adjusted (sex, age, calendar year) and fully adjusted models (additionally including time-updated CD4 count).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 2 770 200 PWH with 10 175 incident cancers; most common were cervical cancer (N = 2481), Kaposi sarcoma (N = 1902), breast cancer (N = 1063), and non-Hodgkin lymphoma (N = 863). Hazard ratios for the association of HIV-1 viremia and cancer risk changed after partial and full adjustment and were generally attenuated for infection-related cancers but tended to increase for infection-unrelated cancers. In the fully adjusted model, HIV-1 viremia was associated with an increased risk of Kaposi sarcoma (HR per unit increase in Log10 HIV-1 RNA viral load: 1.38; 95% confidence interval [CI], 1.35\u20131.42), leukemia (HR: 1.28; 95% CI, 1.13\u20131.45), non-Hodgkin lymphoma (HR: 1.24; 95% CI, 1.19\u20131.29), conjunctival cancer (HR: 1.19; 95% CI, 1.11\u20131.25), and colorectal cancer (HR: 1.11; 95% CI, 1.02\u20131.21). Associations with other cancer types were weaker or absent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings underline the importance of sustained viral suppression for cancer prevention among PWH in South Africa.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae652","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T12:51:12Z","timestamp":1735563072000},"page":"286-295","source":"Crossref","is-referenced-by-count":5,"title":["HIV-1 Viremia and Cancer Risk in 2.8 Million People: The South African HIV Cancer Match Study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-2448","authenticated-orcid":false,"given":"Yann","family":"Ruffieux","sequence":"first","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Mwansa-Kambafwile","sequence":"additional","affiliation":[{"name":"National Cancer Registry, National Health Laboratory Service , Johannesburg ,","place":["South Africa"]},{"name":"School of Public Health, University of Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1331-8280","authenticated-orcid":false,"given":"Carole","family":"Metekoua","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"National Cancer Registry, National Health Laboratory Service , Johannesburg ,","place":["South Africa"]},{"name":"Graduate School for Health Sciences, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tinashe","family":"Tombe-Nyahuma","sequence":"additional","affiliation":[{"name":"National Cancer Registry, National Health Laboratory Service , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1955-1585","authenticated-orcid":false,"given":"Julia","family":"Bohlius","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Swiss Tropical and Public Health Institute , Allschwil ,","place":["Switzerland"]},{"name":"University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1955-923X","authenticated-orcid":false,"given":"Mazvita","family":"Muchengeti","sequence":"additional","affiliation":[{"name":"National Cancer Registry, National Health Laboratory Service , Johannesburg ,","place":["South Africa"]},{"name":"School of Public Health, University of Witwatersrand , Johannesburg ,","place":["South Africa"]},{"name":"South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University , Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-5132","authenticated-orcid":false,"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]},{"name":"Population Health Sciences, Bristol Medical School, University of Bristol , Bristol ,","place":["United Kingdom"]},{"name":"Centre for Infectious Disease Epidemiology and Research (CIDER), School of Public Health, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-2875","authenticated-orcid":false,"given":"Eliane","family":"Rohner","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"2025091917001295600_ciae652-B1","first-page":"215","article-title":"Biological agents","volume":"100 B","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2012","journal-title":"IARC Monogr Eval Carcinog Risks Hum"},{"key":"2025091917001295600_ciae652-B2","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/S1470-2045(09)70282-7","article-title":"Effect of immunodeficiency, HIV viral load, and antiretroviral therapy on the risk of individual malignancies (FHDH-ANRS CO4): a 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