Associations of CD4 Cell Count Measures With Infection-Related and Infection-Unrelated Cancer Risk Among People With...

Area of Science:

• Immunology
• Oncology
• Epidemiology

Background:

• People with HIV (human immunodeficiency virus) have a higher risk of infection-related cancers, potentially due to immune dysfunction.
• CD4 counts are key indicators of immune function in individuals with HIV.

Purpose of the Study:

• To investigate the association between four CD4 count measures and the risk of infection-related and infection-unrelated cancers in adults with HIV.
• To understand how different indicators of immune function impact cancer risk in the HIV-positive population.

Main Methods:

• A cohort study was conducted in Ontario, Canada, involving adults diagnosed with cancer between 1997 and 2020.
• Adjusted hazard ratios were estimated for associations between CD4 measures (baseline, nadir, time-updated, CD4:CD8 ratio) and cancer incidence, controlling for various risk factors.

Main Results:

• Low baseline CD4 (<200 cells/µL), nadir CD4 (<200 cells/µL), low time-updated CD4, and a low time-updated CD4:CD8 ratio (<0.4) were associated with increased rates of infection-related cancers.
• These associations were observed across different CD4 measures, indicating a consistent link between immune status and cancer risk.
• No significant associations were found between CD4 measures and infection-unrelated cancers.

Conclusions:

• Reduced CD4 counts and indices are significantly associated with higher rates of infection-related cancers in people with HIV.
• Strategies focusing on early diagnosis, linkage to care, antiretroviral therapy, cancer screening, and vaccination are vital for cancer prevention in this cohort.