Individuals infected with human immunodeficiency virus (HIV) who are on statin therapy are significantly less likely to develop cancer, researchers said here at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention.
In a retrospective analysis, Vincenzo Spagnuolo, MD, a resident in infectious diseases at Ospedale San Raffaele, Milan, observed that 363 individuals out of 4617 who were not on statins (7.9%) were diagnosed with cancer compared with 12 of 740 patients on statins (1.3%).
After adjusting for variables, patients who were on statins and were HIV-positive had a 46% reduced risk of cancer (P
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"We looked at more than 10 years of treatment records," he told MedPage Today
, "and we found that the protection of statins was even greater when we considered cancers that are considered AIDS-defining illnesses -- non-Hodgkin lymphoma, Kaposi's sarcoma and uterine cervical cancer."
None of these cancers were observed in patients on statins, but 194 of these cancers occurred among patients who were not on statins, he said.
"Statin use has been recently associated with reduced cancer incidence and mortality both in the general population and among HIV-infected subjects," Spagnuolo said. "Based on these encouraging results we hypothesized that statin use begun after the start of antiretroviral therapy and before a cancer diagnosis would be associated with reduced cancer occurrence."
Spagnuolo and his research team analyzed medical records of patients at Ospedale San Raffaele, identifying 5,357 patients who were followed for an average of 10.3 years -- totaling 52,663 person-years of follow-up.
Overall, the crude cancer rate was 7.1 cases per 1000 person-years of follow-up among all the patients included in the study. The incidence rate was 8.4 per 1000 person-years of follow-up among those not on statins and 1.3 per 1000 person-years of follow-up for those individuals who were assigned statin treatment.
Spagnuolo noted that the statin users were about 51 years of age, and the nonstatin patients were about 46 years of age – a significant difference, favoring nonstatin use (P
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The statin users were significantly more likely to be men (80%), (P
=0.028). The statin users had been diagnosed with HIV for about 2 years longer than the nonstatin group, and those taking statins had been treated with highly active antiretroviral therapy longer as well. There was no significant difference in the two groups as far as CD4-positive cell count was concerned.
Patients were taking statins for a mean of 24.7 months, Spagnuolo said.
"We have known for some time that statins have anti-inflammatory effects," said Julio Montaner, MD, professor of medicine at the University of British Columbia, Vancouver. "And there is belief that an inflammatory condition can predispose toward cancer, so it could be through this mechanism that statins are protecting against cancer."
But he told MedPage Today
, that putting together a prospective clinical trial to prove the relationship would be a massive undertaking.
Spagnuolo had no disclosures.
Montaner disclosed his center performs research for Gilead, Merck, GlaxoSmithKline, Bristol-Myers Squibb and multiple other pharmaceutical companies.
Primary source: International AIDS Society
Source reference:
Spagnuolo V, et al "Association between HMG-CoA reductase inhibitors (statins) use and cancer occurrence among HIV-1 treated patients" IAS
2013.
