Use of statins and risk of AIDS-defining and non-AIDS-defining malignancies among HIV-1 infected patients on antiretroviral therapy-猫眼课题宝

DOI：

10.1097/qad.0000000000000443

发表时间：

2014-10-01

期刊：

AIDS

影响因子：

3.8

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Galli, Laura;Spagnuolo, Vincenzo;Castagna, Antonella

目的：先前的研究表明，在hiv阳性患者中，他汀类药物的使用与较低的死亡风险或非霍奇金淋巴瘤或非艾滋病定义恶性肿瘤（NADMs）的发生有关。我们评估了他汀类药物治疗对hiv阳性患者中所有艾滋病定义恶性肿瘤（ADM）和NADM发生的影响。设计：对在意大利圣拉斐尔科学研究所传染病科就诊的HIV-1感染患者进行图表研究。方法：在开始抗逆转录病毒治疗（ART）至2012年10月期间未服用他汀类药物的患者中诊断为恶性肿瘤的事件。如果发生癌症，他汀类药物治疗必须在癌症诊断之前进行。排除抗逆转录病毒治疗或他汀类药物治疗前发生的恶性肿瘤。随访从ART开始计算，直到第一次癌症诊断或随访失败或死亡或最后一次可访问，以先发生者为准。结果被描述为中位数（四分位数范围，IQR）。结果：共纳入5000357例HIV-1治疗患者。在52663人年中，740例（14%）患者有他汀类药物使用史；发生了375例恶性肿瘤：他汀类药物服用者中有12例（1.6%）恶性肿瘤（0例ADM； 12例NADM，粗发病率1.3/1000人年），非他汀类药物服用者中有363例（7.9%）恶性肿瘤（194例ADM； 169例NADM，粗发病率8.4/1000人年）。通过多变量Fine-Gray回归，他汀类药物的使用与较低的癌症风险相关[校正风险比（95%置信区间）：0.45(0.17-0.71)]。结论：在HIV-1治疗的患者中，他汀类药物的使用与较低的癌症风险相关；获益主要与艾滋病定义的恶性肿瘤有关。需要验证性研究来考虑本研究中可能存在的残留混杂因素。(C) 2014年Wolters Kluwer Health垂直条Lippincott Williams & Wilkins

Objective: Previous studies have shown that statins use is associated with a lower mortality risk or occurrence of non-Hodgkin's lymphoma or non-AIDS-defining malignancies (NADMs) in HIV-positive patients. We evaluated the effect of statin therapy on the occurrence of all AIDS-defining malignancy (ADM) and NADM among HIV-positive patients.Design: A chart study on HIV-1 infected patients attending the Infectious Diseases Department of the San Raffaele Scientific Institute, Italy.Methods: Incident malignancies diagnosed since antiretroviral treatment (ART) initiation until October 2012 among treated patients not taking statins at ART initiation. Statin therapy had to precede cancer diagnosis, if it occurred. Malignancies that occurred before ART or statin initiation were excluded. Follow-up was calculated since ART initiation until the first cancer diagnosis or loss to follow-up or death or last available visit, whichever occurred first. Results are described as median (interquartile range, IQR).Results: Five thousand, three hundred and fifty-seven HIV-1 treated patients were included. During 52 663 person-years, 740 (14%) patients had a history of statin use; 375 malignancies occurred: 12 (1.6%) malignancies (0 ADM; 12 NADM, crude incidence rate, 1.3/1000 person-years) among statin users and 363 (7.9%) malignancies (194 ADM; 169 NADM, crude incidence rate, 8.4/1000 person-years) among non-statin users. By multivariate Fine-Gray regression, statin use was associated with a lower risk of cancer [adjusted hazard ratio (95% confidence interval) for ever use: 0.45 (0.17-0.71)].Conclusion: Among HIV-1 treated patients, statin use was associated with a lower risk of cancer; the benefit was mainly related to AIDS-defining malignancies. Confirmatory studies are needed to consider the residual confounding likely present in this study. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Use of statins and risk of AIDS-defining and non-AIDS-defining malignancies among HIV-1 infected patients on antiretroviral therapy

文献摘要

被引文献

相似文献