Having HIV and chronic HBV/HCV coinfection may increase cancer risk

1. Having HIV and chronic HBV/HCV coinfection may increase cancer risk

Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-0240

URLs go live when the embargo lifts

In HIV-infected patients receiving antiretroviral therapy (ART), chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection is associated with an increased risk for non-Hodgkin's lymphoma. The findings are published in Annals of Internal Medicine.

The incidence rate of non-Hodgkin's lymphoma in HIV-infected persons is about 10 times higher than in the HIV-negative population, and is an important cause of AIDS and death, even for patients receiving ART. Growing evidence indicates that some infections increase the risk for non-Hodgkin's lymphoma through chronic immune stimulation that occurs in immunocompromised patients. It is unclear whether chronic HBV an HCV infection promote non-Hodgkin's lymphoma in HIV-infected patients.

Researchers studied 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) to investigate whether chronic HBV and HCV infection are associated with increased incidence of non-Hodgkin's lymphoma. The authors included 52,479 ART-naïve patients, 40,219 of whom later started ART. Some patients had HBV, HCV, or dual infection at the time of inclusion into cohorts, and some others acquired infection during the follow up phase. The researchers found that the ART-treated patients with chronic HBV or HCV infection were at increased risk for non-Hodgkin's lymphoma compared with uninfected persons. The authors conclude that early diagnosis and treatment of HIV infection in conjunction with routine screening for chronic HBV an HCV infection is essential to further decrease non-Hodgkin's lymphoma morbidity and mortality in HIV-infected persons.

Note: For an embargoed PDF or author contact information, please contact Cara Graeff.

2. Patients hospitalized for accidental firearm injuries more likely to have a violence-related arrest

Firearm injury, regardless of intent, presents an opportunity for intervention

Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-1596

Editorial: http://www.annals.org/article.aspx?doi=10.7326/M16-2244

URLs go live when the embargo lifts

Patients hospitalized with accidental firearm injuries are likely to be involved in the cycle of violence and should be considered for hospital-based violence prevention interventions. The findings are published in Annals of Internal Medicine.

Regardless of intent, many patients with nonfatal firearm injuries have short-term, long-term, or permanent physical and psychological issues that translate into loss of healthy life-years and considerable societal costs. Effective violence prevention strategies are critically needed to reduce the heavy burden of firearm injuries. Understanding the pattern of violence before and after firearm injury can inform those interventions in the community and in the health care setting.

Researchers compared the odds of violence-related arrest from 2001 through hospitalization by injury intent among three patient groups - those with unintentional firearm injuries, those with other unintentional injuries, and those with no injuries. The researchers found that patients hospitalized with an unintentional firearm injury were more likely than the other groups to have a prior violence-related arrest. Prior violence-related arrest did not differ between patients with unintentional or assault-related injuries, suggesting that any type of firearm injury represents an opportunity for intervention. The researchers conclude that patients hospitalized with a firearm injury should be considered for hospital-based violence prevention interventions.

Note: For embargoed PDFs, please contact Cara Graeff. The lead author, Dr. Ali Rowhani-Rahbar, can be reached through Jeff Hodson at jeffhod@uw.edu or Erica MacArthur at ermepi@uw.edu.

Also new in this issue:

Patient Experience Must Move Beyond Bad Apples

Azita Hamedani, MD, MPH, MBA; Basmah Safdar, MD; Emily Aaronson, MD; and Thomas H. Lee, MD

Ideas and Opinions

Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-1725

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