Currently approved 2-drug therapies are as effective as 3-drug regimens but could potentially lead to increased cancer risk due to less efficient immune recovery. We conducted a longitudinal cohort study in a tertiary Italian hospital to investigate HIV+ patients starting a triple therapy (TT) (2 NRTIs +3rd agent) or a dual therapy (DT) (3TC/FTC+boosted-PI, boosted-DRV+RAL, and 3TC/FTC or RPV+DTG) regimen between 2009 and 2018. The effect of DT (vs. TT) on tumor onset was evaluated by the multivariable Cox regression and the marginal structural Cox model, after estimating the inverse probability of treatment weights (IPTW). One thousand one hundred and seven patients who had a median follow-up of 4.2 person-years (py) were evaluated; 69.2% were males, with a median age of 43 years. Overall 2,513 treatments were started during the study period (479 DT, 2,034 TT). Eight tumors occurred over 965 py with DT and 35 over 3,817 py during TT (p = .797). In the Cox regression, DT did not predict an increased risk of tumor compared with TT (HR 1.14; p = .757) after adjusting for potential confounders. A marginal structural model using IPTW (HR 0.68; p = .328) and stabilized IPTW (HR 0.69; p = .361) confirmed this result. Preliminary findings from our cohort do not suggest an increased risk of tumors with DT compared to TT.

中文翻译：

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接受两种药物治疗的 HIV+ 患者的肿瘤发病风险：意大利医院的一项队列研究

目前批准的 2 种药物疗法与 3 种药物疗法一样有效，但由于免疫恢复效率较低，可能会导致癌症风险增加。我们在意大利一家三级医院进行了一项纵向队列研究，以调查开始三联疗法 (TT)（2 NRTIs +第三剂）或双重疗法 (DT)（3TC/FTC+boosted-PI、boosted-DRV+RAL）的 HIV+ 患者和 3TC/FTC 或 RPV+DTG) 方案在 2009 年至 2018 年之间。在估计治疗权重的逆概率后，通过多变量 Cox 回归和边际结构 Cox 模型评估 DT（vs. TT）对肿瘤发作的影响(IPTW)。对 1107 名中位随访时间为 4.2 人年 (py) 的患者进行了评估；69.2% 为男性，中位年龄为 43 岁。总体 2, 在研究期间开始了 51​​3 次治疗（479 DT，2,034 TT）。8 个肿瘤在 DT 期间发生超过 965 py，在 TT 期间发生超过 3,817 py（p  = .797）。在 Cox 回归中， 在调整潜在混杂因素后，与 TT 相比，DT 并未预测肿瘤风险增加（HR 1.14；p = .757）。使用 IPTW (HR 0.68; p  = .328) 和稳定 IPTW (HR 0.69; p  = .361)的边缘结构模型证实了这一结果。我们队列的初步发现并不表明与 TT 相比，DT 的肿瘤风险增加。