{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:39:54Z","timestamp":1789792794615,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Barcelona Antiretroviral Surveillance Study ("}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of long-term virological suppression (VS) and CD4 count recovery on non\u2013AIDS-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 \u22652 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 48 343 people with VS were included (median [interquartile range] baseline age, 43 years [37\u201350]; CD4 count, 540 cells\/\u00b5L [380\u2013730]; nadir CD4 count, 245 cells\/\u00b5L [121\u2013394]; 74% male). There were 1933 incident cancers (median follow-up, 6.2 years [2.9\u20139.5]; incidence rate [IR], 6.43; 95% confidence interval [CI]: 6.15\u20136.73\/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\u2013499 cells\/\u00b5L: 0.45 [95% CI: 0.39\u20130.51]; 500\u2013749 cells\/\u00b5L: 0.30 [95% CI: 0.27\u20130.34]; and \u2265750 cells\/\u00b5L: 0.26 [95% CI: 0.23\u20130.30] vs &amp;lt;350 cells\/\u00b5L; P &amp;lt; .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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf248","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T08:03:44Z","timestamp":1747123424000},"page":"e338-e351","source":"Crossref","is-referenced-by-count":16,"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"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3731-7960","authenticated-orcid":false,"given":"Win Min","family":"Han","sequence":"first","affiliation":[{"name":"Kirby Institute, UNSW , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene","family":"Ryom","sequence":"additional","affiliation":[{"name":"CHIP, Rigshospitalet , Copenhagen ,","place":["Denmark"]},{"name":"Department of Infectious Diseases, Hvidovre University Hospital , Copenhagen ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5173-2760","authenticated-orcid":false,"given":"Caroline A","family":"Sabin","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Greenberg","sequence":"additional","affiliation":[{"name":"CHIP, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0933-7833","authenticated-orcid":false,"given":"Matthias","family":"Cavassini","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Lausanne University Hospital , Lausanne ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Egle","sequence":"additional","affiliation":[{"name":"3rd Medical University Department, Paracelsus Medical University, Salzburg ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudine","family":"Duvivier","sequence":"additional","affiliation":[{"name":"AP-HP H\u00f4pital Necker-Enfants Malades, Universit\u00e9 Paris Cit\u00e9 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2066-8115","authenticated-orcid":false,"given":"Ferdinand W N M","family":"Wit","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring Foundation , Amsterdam, The Netherlands"},{"name":"Department of Infectious Diseases, Amsterdam Institute for Immunology and Infectious Disease, Amsterdam University Medical Center, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mussini","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Universit\u00e0 Degli Studi di Modena , Modena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"d\u2019Arminio Monforte","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, ASST Santi Paolo e Carlo , Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6481-4570","authenticated-orcid":false,"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute, Universit\u00e0 Vita-Salute San Raffaele , Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-7755","authenticated-orcid":false,"given":"Jose M","family":"Miro","sequence":"additional","affiliation":[{"name":"Hospital Clinic-IDIBAPS, University of Barcelona and Reial Academia de Medicina de Catalunya , Barcelona, Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"van der Valk","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring Foundation , Amsterdam, The Netherlands"},{"name":"Department of Infectious Diseases, Amsterdam Institute for Immunology and Infectious Disease, Amsterdam University Medical Center, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5927-4178","authenticated-orcid":false,"given":"Fabrice","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Service de M\u00e9dicine Interne et Maladies, Infectieuses, CHU de Bordeaux and Bordeaux University, BPH, INSERM U1219 , Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0676-6379","authenticated-orcid":false,"given":"Christian","family":"Pradier","sequence":"additional","affiliation":[{"name":"Department of Public Health, Prevention and Health Promotion, Universit\u00e9 C\u00f4te D\u2019Azur et Centre Hospitalier Universitaire , Nice ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Skocic","sequence":"additional","affiliation":[{"name":"3rd Medical University Department, Paracelsus Medical University, Salzburg ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4791-3133","authenticated-orcid":false,"given":"Raimonda","family":"Matulionyte","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Dermatovenerology, Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0088-5078","authenticated-orcid":false,"given":"Marcel","family":"St\u00f6ckle","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Jaschinski","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hvidovre University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Timiryasova","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hvidovre University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7655-9068","authenticated-orcid":false,"given":"Joan","family":"Tallada","sequence":"additional","affiliation":[{"name":"European AIDS Treatment Group , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe P","family":"Rogatto","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc , Foster City, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vani","family":"Vannappagari","sequence":"additional","affiliation":[{"name":"ViiV Healthcare, Research Triangle Park , North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lital A","family":"Young","sequence":"additional","affiliation":[{"name":"Merck Sharp & Dohme , Rahway, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-7850","authenticated-orcid":false,"given":"Jens D","family":"Lundgren","sequence":"additional","affiliation":[{"name":"CHIP, Rigshospitalet , Copenhagen ,","place":["Denmark"]},{"name":"Department of Infectious Diseases, Hvidovre University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Petoumenos","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW , Sydney, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6948-7086","authenticated-orcid":false,"given":"Jennifer F","family":"Hoy","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Alfred Hospital and Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"2025122403221755200_ciaf248-B1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1468-1293.2012.00996.x","article-title":"Relative risk of cardiovascular disease among people living with HIV: a systematic review and meta-analysis","volume":"13","author":"Islam","year":"2012","journal-title":"HIV Med"},{"key":"2025122403221755200_ciaf248-B2","doi-asserted-by":"crossref","first-page":"e495","DOI":"10.1016\/S2352-3018(17)30125-X","article-title":"Cancer 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Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort","volume":"49","author":"Bruyand","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2025122403221755200_ciaf248-B23","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1093\/cid\/cir207","article-title":"Immunodeficiency as a risk factor for non-AIDS-defining malignancies in HIV-1-infected patients receiving combination antiretroviral therapy","volume":"52","author":"Kesselring","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2025122403221755200_ciaf248-B24","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1093\/cid\/cit232","article-title":"CD4 decline is associated with increased risk of cardiovascular disease, cancer, and death in virally suppressed patients with HIV","volume":"57","author":"Helleberg","year":"2013","journal-title":"Clin Infect 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