No link between treatment with antidepressants and risk of cancer in people with HIV

Treatment with antidepressants does not increase the risk of any kind of cancer in people with HIV, according to a UK study published in the May 10^th edition of the Journal of Clinical Oncology. The researchers looked at the use of both older tricyclic antidepressants and more modern SSRI antidepressants, such as fluoxetine, by people with HIV in both the period before and after effective anti-HIV treatment became available. No link between the use of antidepressants was found in any time period.

There is conflicting information about the link between use of both tricyclic and SSRI antidepressants and the risk of cancer. Some studies have suggested a link between their use and the risk of some cancers, but others have not. By contrast, some research has suggested that treatment with SSRI antidepressants could have an anti-cancer effect in patients with Burkitt lymphoma.

No study has looked at the link between treatment with tricyclic or SSRI antidepressants and the risk of cancer in people with HIV in either the period before or after effective anti-HIV treatment became available. Nor has any study previously looked for a possible link between cancer and treatment with antidepressants and the individual classes of antiretroviral drugs.

Therefore researchers at London’s Chelsea and Westminster Hospital looked through the medical records of the 11,000 patients who have received HIV care at the hospital. They found that 952 of these patients had received treatment with an SSRI antidepressant and 919 with a tricyclic antidepressant. A total of 144 of these patients (9%) were treated with an antidepressant in the three months before they were diagnosed with a cancer of any kind.

But the researchers could find no association between the use of any kind of antidepressant and the development of cancer in either the period before or after anti-HIV treatment was introduced. Nor were they able to see any connection between the use of any kind of antidepressant and a risk of cancer in patients taking any of the classes of antiretroviral drug.

The only factor that they could find with a connection with the risk of cancer was a lower CD4 cell count.

Further analysis failed to find any negative or beneficial effects of treatment with an SSRI in patients diagnosed with non-Hodgkin’s lymphoma, Kaposi’s sarcoma, lymphomas of the central nervous system or Burkitt lymphoma.

“We found that in HIV-infected individuals who are predisposed to a wide range of cancers, different antidepressants are not associated with a change in cancer risk, in either the pre-[highly active antiretroviral therapy] or the [highly active antiretroviral therapy] era”, write the investigators.

They note that potential benefits of antidepressant treatment for some HIV-positive patients with depression, referring to studies showing that their use can boost treatment adherence in such patients.