Diapos Dominique Costagliola - TRT-5

Epidémiologie des cancers chez
les patients infectés par le VIH
D Costagliola, INSERM U 720

CONTEXTE (1)
Association entre l’immuno-dépression induite par le VIH et certains cancers est bien
établie
SK, LNH, LCP Définition SIDA 1987
Cancer du col utérin plus discuté 1993
Certains cancers non classant SIDA sont aussi augmentés chez les patients VIH
RR sont beaucoup plus faibles
Excepté Maladie de Hodgkin, résultats discordants selon les études sur les types de
tumeurs augmentées (poumon, myélome, séminomes testiculaires, leucémies, …)
Rôle causal VIH difficile. Rôle de cofacteurs pas toujours disponibles

Données récentes dans la base
de données hospitalière
française sur l’infection à VIH
(FHDH - ANRS CO 04)

The database
•Established in 1992 (since 1984 in some centres), 62 hospitals.
•Inclusion criteria :
–HIV-1 or HIV-2 infection
–Followed in a participating ward
–Written informed consent
•Data are collected prospectively by clinical research assistants
–Age, sex, transmission group, diagnosis linked or not with HIV infection
–CD4 cell count, HIV-RNA)
–Treatments
From medical records using a standardized form
Entered locally using the DMI2 software
At each in or out)patient visit with a clinical event or therapeutic event or at least every 6
months
•Patients are identified through an unlinked code generated at time of extraction
from last and first name and day and month of birth
•The database is running with Oracle and analysed with SAS

Data quality
•Validation
•Audit
•Validation of some data are possible by local check in the medical
record
•>101 800 subjects including 94 601 with at least one follow-up
between 1992 and 2003, with a mean follow-up of 55 months, and
41 683 patients followed en 2003
•Representativeness
–Characteristics of patients very similar to those observed in the VESPA
study which included ward participating and not participating to the
database
•Completeness
–Estimated in 1993 by linking with mandatory reporting of AIDS diagnosis
–53,5 %