In:
AIDS, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 2 ( 2021-02-2), p. 325-334
Abstract:
To determine whether statin exposure is associated with decreased cancer and mortality risk among persons with HIV (PWH) and uninfected persons. Statins appear to have immunomodulatory and anti-inflammatory effects and may reduce cancer risk, particularly among PWH as they experience chronic inflammation and immune activation. Design: Propensity score-matched cohort of statin-exposed and unexposed patients from 2002 to 2017 in the Veterans Aging Cohort Study (VACS), a large cohort with cancer registry linkage and detailed pharmacy data. Methods: We calculated Cox regression hazard ratios (HRs) and 95% confidence intervals (CI) associated with statin use for all cancers, microbial cancers (associated with bacterial or oncovirus coinfection), nonmicrobial cancers, and mortality. Results: :The propensity score-matched sample ( N = 47 940) included 23 970 statin initiators (31% PWH). Incident cancers were diagnosed in 1160 PWH and 2116 uninfected patients. Death was reported in 1667 (7.0%) statin-exposed, and 2215 (9.2%) unexposed patients. Statin use was associated with 24% decreased risk of microbial-associated cancers (hazard ratio 0.76; 95% CI 0.69–0.85), but was not associated with nonmicrobial cancer risk (hazard ratio 1.00; 95% CI 0.92–1.09). Statin use was associated with 33% lower risk of death overall (hazard ratio 0.67; 95% CI 0.63–0.72). Results were similar in analyses stratified by HIV status, except for non-Hodgkin lymphoma where statin use was associated with reduced risk (hazard ratio 0.56; 95% CI 0.38–0.83) for PWH, but not for uninfected ( P interaction = 0.012). Conclusion: In both PWH and uninfected, statin exposure was associated with lower risk of microbial, but not nonmicrobial cancer incidence, and with decreased mortality.
Type of Medium:
Online Resource
ISSN:
0269-9370
,
1473-5571
DOI:
10.1097/QAD.0000000000002748
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
2012212-3
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