TY - JOUR
T1 - Risk of cancer after tuberculosis disease among people with HIV in Denmark
T2 - a nationwide population-based cohort study
AU - Kraef, Christian
AU - Omland, Lars Haukali
AU - Porskrog, Anders
AU - Larsen, Carsten Schade
AU - Dalager-Pedersen, Michael
AU - Kronborg, Gitte
AU - Gerstoft, Jan
AU - Kirk, Ole
AU - Obel, Niels
AU - Johansen, Isik Somuncu
N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2025/9/15
Y1 - 2025/9/15
N2 - BACKGROUND: The long-term cancer risk following tuberculosis disease in people with human immunodeficiency virus (HIV) remains unclear. We aimed to assess cancer risk following tuberculosis in a nationwide cohort of people with HIV in Denmark.METHODS: We conducted a population-based cohort study including all individuals enrolled in the Danish HIV Cohort Study from 1995 to 2020. Tuberculosis and cancer diagnoses were identified through nationwide registries. Incidence rates (IRs) and adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression, adjusting for time-varying CD4 count, age, sex, and Charlson Comorbidity Index (CCI). Additionally, we calculated aIRRs stratified by age group, sex, CCI, and CD4 count.RESULTS: Among 6135 people with HIV (median age, 37.1 years; 74.1% male), 319 had a tuberculosis diagnosis. During 62 878 person-years of follow-up (PYFU), 451 cancers were observed, including 55 lung cancers. The overall cancer IR among people with HIV without previous tuberculosis disease was 18.6 per 1000 PYFU (95% confidence interval [CI], 16.9-20.4), and 19.0 per 1000 PYFU (95% CI, 10.4-25.6) among people with HIV following tuberculosis (aIRR, 1.1; 95% CI, .7-1.8). For lung cancer, the aIRR after tuberculosis was 1.7 (95% CI, .5-5.5). In stratified analyses, aIRRs were slightly higher among women (1.3; 95% CI, .6-2.9) and those aged ≥50 years (1.4; 95% CI, .8-2.4).CONCLUSIONS: In this nationwide cohort of more than 6000 people with HIV followed for up to 25 years, we observed no increased risk of cancer following tuberculosis disease. These findings do not support changes to continued standardized cancer surveillance in people with HIV and tuberculosis.
AB - BACKGROUND: The long-term cancer risk following tuberculosis disease in people with human immunodeficiency virus (HIV) remains unclear. We aimed to assess cancer risk following tuberculosis in a nationwide cohort of people with HIV in Denmark.METHODS: We conducted a population-based cohort study including all individuals enrolled in the Danish HIV Cohort Study from 1995 to 2020. Tuberculosis and cancer diagnoses were identified through nationwide registries. Incidence rates (IRs) and adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression, adjusting for time-varying CD4 count, age, sex, and Charlson Comorbidity Index (CCI). Additionally, we calculated aIRRs stratified by age group, sex, CCI, and CD4 count.RESULTS: Among 6135 people with HIV (median age, 37.1 years; 74.1% male), 319 had a tuberculosis diagnosis. During 62 878 person-years of follow-up (PYFU), 451 cancers were observed, including 55 lung cancers. The overall cancer IR among people with HIV without previous tuberculosis disease was 18.6 per 1000 PYFU (95% confidence interval [CI], 16.9-20.4), and 19.0 per 1000 PYFU (95% CI, 10.4-25.6) among people with HIV following tuberculosis (aIRR, 1.1; 95% CI, .7-1.8). For lung cancer, the aIRR after tuberculosis was 1.7 (95% CI, .5-5.5). In stratified analyses, aIRRs were slightly higher among women (1.3; 95% CI, .6-2.9) and those aged ≥50 years (1.4; 95% CI, .8-2.4).CONCLUSIONS: In this nationwide cohort of more than 6000 people with HIV followed for up to 25 years, we observed no increased risk of cancer following tuberculosis disease. These findings do not support changes to continued standardized cancer surveillance in people with HIV and tuberculosis.
KW - Denmark
KW - HIV/AIDS
KW - cancer
KW - cohort study
KW - tuberculosis
UR - https://www.scopus.com/pages/publications/105016797387
U2 - 10.1093/infdis/jiaf341
DO - 10.1093/infdis/jiaf341
M3 - Journal article
C2 - 40562407
SN - 0022-1899
VL - 232
SP - 612
EP - 619
JO - The Journal of infectious diseases
JF - The Journal of infectious diseases
IS - 3
ER -