Pattern of cancer risk in persons with AIDS in Italy in the HAART era
Pattern of cancer risk in persons with AIDS in Italy in the HAART era
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DOI：
10.1038/sj.bjc.6604923
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发表时间：
2009-03-03
影响因子：
8.8
通讯作者：
Franceschi, S.
中科院分区：
文献类型：
--
作者：
Dal Maso, L.;Polesel, J.;Franceschi, S.
在意大利艾滋病登记处和24个意大利癌症登记处之间进行了一项记录联系研究，以比较1996年采用高效抗逆转录病毒疗法前后艾滋病毒/艾滋病（PWHA）患者的癌症发病率。计算了1986年至2005年期间报告的21951例16-69岁艾滋病病例的标准化发病率（SIR）。在101 669人年中，有45 026人年是在1996年之后。与1986-1996年相比，1997-2004年Kaposi肉瘤（KS）和非霍奇金淋巴瘤的SIR显著下降，但在首次HIV阳性检测与AIDS诊断间隔< 1年的PWHA中，KS的高SIR持续存在。肝癌的显著过量（SIR 6.4）出现在1997-2004年，而宫颈癌的SIR（41.5），肛门在这两个时期内，肺癌（4.1）、脑癌（3.2）、皮肤癌（非黑色素瘤，1.8）、霍奇金淋巴瘤（20.7）、骨髓瘤（3.9）和非AIDS定义的癌症（2.2）的发病率同样升高。PWHA中一些潜在可预防的癌症的过量表明，HAART的使用必须伴随着癌症预防策略，特别是反吸烟和宫颈癌筛查计划。及时发现艾滋病毒抗体阳性者也是意大利的一个优先事项，以避免延迟使用高效抗逆转录病毒疗法的不良后果。
A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16-69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997-2004 compared with 1986-1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of < 1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR 6.4) emerged in 1997-2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.