Definitions of Complicated Urinary Tract Infection and Pyelonephritis
Clinical Infectious Diseases®
0 Medical Research Council Clinical Trials Unit at University College London , United Kingdom
1 Division of Biostatistics, School of Public Health, University of Minnesota , Minneapolis , USA
2 Diseases, Section 2100, Rigshospitalet, University of Copenhagen , Blegdamsvej 9, 2100 Copenhagen Ø , Denmark
3 Centre of Excellence for Health , Immunity and Infections , Department of Infectious Diseases , Rigshospitalet , University of Copenhagen , Denmark
4 Center for Clinical AIDS Research and Education, David Geffen School of Medicine, University of California , Los Angeles , USA
5 Division of Infectious Diseases, Weill Cornell Medicine , New York , New York
CORRESPONDENCE • CID 2017:64 (1 February) • 389
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In our data, the median time fromConflicts that the editors consider relevant to theMeijide and colleagues report the
HIV diagnosis to cancer was 11.0 years content of the manuscript have been disclosed. findings from an investigation involving
(IQR, 4.0-18.0) for NADC and 1.5 years Héctor Meijide,1,2 Álvaro Mena,1 Iria Rodríguez-Osorio,1 HIV-infected persons carried out at their
(0.0–8.2) for ADC. Coinfected patients Ángeles Castro-Iglesias1 and Eva Poveda1 hospital in Spain 1[]. They retrosp-ec
developed NADC 6.0 years (3.0–8.3) Bioméd1icGarudpeoAd eCoVriuroñlao–gCíaomClpínleicxao, HInosstpitiutatoladrieoIUnvneivsetirgsaitcairóion tively classified malignancies into
AIDSlater than monoinfected patients and de A Coruña, Sergas, Universidade da Coruña; and 2Servicio defining and non-AIDS-defining cancer.
ADC 7.1 years (3.5–10.4) laterF(igure 1). de Medicina Interna, Hospital Quirón, A Coruña, Spain An association was found between h-ep
The median time from HIV diagnosis to atitis C virus (HCV) coinfection and risk
randomization in START was 1 year and, References for non-AIDS-defining cancer in analyses
caaftnecrerthwaats, 0t.h7e(0t.i3m–e3.4t)oyienafresctainodn-rteolate1d.IoBmfomrigneedfseicattÁieHon,a-nrNteleiarutehetadruosvciarJn,acleBratbhidekureraripnygAGree,adreulytce sHalI.rVisarkdojuutset.eOdfnorthageeb,saesxis, aonfdtHhiIsV, ttrhaenysmhyipsso-iothne
infection-unrelated cancer was 2.3 (0.6– infection [manuscript published online ahead of size that HCV coinfection may facilitate
4.9) years; the maximum follow-up was 5 pdroiin:1t0.1809S3e/pctiedm/cbiwer6 212.016]. Clin Infect D2is016. the development of malignancies other
years. After 5 years, in our cohort, close to2. Lundgren JD, Babiker AG, Gordin F, et al; INSIGHT than hepatocellular carcinoma (HCC).
40% of NADCs were diagnosed in HIV- StThAerRaTpyStinudeyarGlyroausypm.pIntiotmiaattioicnHoIfVainntfiercettioronv.iNral A direct comparison between Meijide
monoinfected patients, but only just over Engl J Med2015; 373:795–807. et al’s results and our report is difficult
10% in HCV-coinfected patients. With 3. XAulliFs,oentR aDl.,ITnocnrgeaXs,eMdoinocridmeannceACof, LcyanKcNer, Raunpdpc-La,n owing to differences in recruitment period,
a longer follow-up in the START trial, cer-related mortality among persons with chronisctudy design, and categorization of m-alig
amnaiinnlcyreinafseecotifocnanucnerreelavteendt;sitisceoxupledctheedlp, 6h3e:p8a2t2i–t8i.s C infection, 2006–2010. J Hepat2o0l15; nwaencoipest.eAdsfomrenctlaiossnifeydinign ionucirdernetpomr2ta]-,li[g
to explore better the differences betweCeonrrespondence: Á. Mena, Grupo de Virología Clínica, nancies in START into infection-related
both strategies, as the authors ackn-owIlnstituto de Investigación Biomédica de A Coruña, Complexo and infection-unrelated cancer. Although
edge properly in the limitations. AH oCsopriutañlaar1io500U6n,iSveprasiinta(railovardoe.mAen aC.doeru.cñeaa,@AssergXausb.eiass). s/n, not perfect, this classification takes into
Our data suggest a role of HCV co-in Clinical Infectious Diseases® 2017;64(3):388–9 account emerging data from epidemiol-ogi
fection in cancer development, beyondt©heTIhnefeActuiothuosrD2is0e1a6s.ePsuSbolicsiheetdy obfyAOmxeforircda.UAnlilvreirgshittys rPerseesrsvefodr. cal surveillance [4] and establishes a fram-e
hepatocellular carcinoma, as data in HIV- For permissions, e-mail . work to study the interactions between
uninfected patients have suggeste3d].[In DOI: 10.1093/cid/ciw759 HIV, coinfection bypro-oncogenic viruses,
START, the independent predictors of and cancer development.
infection-unrelated cancer were older ageReply to Meijide et al Hepatocellular carcinoma is a
nonand baseline CD8 count. Less than 5% of AIDS-defining cancer that may be
patients in START were HCV coinfected, classified as an infection-related or in-fec
but the prevalence was >3 times higher inTo the Editor—We thank Meijide and tion-unrelated malignancy depending on
patients with infection-unrelated cancercolleagues [
1
] for their interest in ou-r arwhether the patient is coinfected or not
than those without cancer. Based on ourticle [
2
]. They rightly point out that thweith HCV or hepatitis B virus (HBV). In
data, with a longer follow (...truncated)