High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.
High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.
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城市艾滋病毒感染者（主要是非洲裔美国人）的癌症相关死亡率很高。
DOI：
10.1097/qad.0b013e32835dc068
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Gilliam,BruceL
中科院分区：
文献类型：
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作者：
Riedel,DavidJ;Mwangi,EvelynIvyW;Fantry,LoriE;Alexander,Carla;Hossain,MianB;Pauza,CDavid;Redfield,RobertR;Gilliam,BruceL
目的：确定死亡率与一个新的癌症诊断在城市，主要是非洲裔美国人，HIV感染population.Design：回顾性队列study.Methods：2000年1月1日和2010年6月30日之间诊断为癌症的所有HIV感染患者进行了审查。死亡率采用Kaplan-Meier估计和考克斯比例风险模型进行分析。患者主要为非洲裔美国人（85%）和男性（79%）。非艾滋病定义的癌症（NADC，69%）比艾滋病定义的癌症（ADC，31%）更常见。在研究期间，累积癌症发病率显著增加。大多数（55.9%）在癌症诊断时接受抗逆转录病毒治疗（ART）或在癌症诊断后开始（26.9%）; 17.2%从未接受过ART。在1096人年的随访中有226人死亡，总死亡率为206/1000人年。30天、1年和2年的累积死亡率分别为6.5%、32.2%和41.4%。ART患者之间的死亡率是相似的，无论他们开始之前或之后的癌症诊断，但更高的患者谁从来没有收到ART. In患者的死亡原因已知，68%与潜在cancer.Conclusion的进展：在一个大型队列的城市，主要是非洲裔美国人的艾滋病毒和癌症患者，许多患者提出了晚期癌症。有大量的30天和2年死亡率，虽然ART有显着的死亡率效益。死亡最常见的原因是癌症进展，而不是其他艾滋病毒或艾滋病相关事件。
Objective:To determine mortality associated with a new cancer diagnosis in an urban, predominantly African–American, HIV-infected population.Design:Retrospective cohort study.Methods:All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan–Meier estimates and Cox proportional hazards models.Results:There were 470 cases of cancer among 447 patients. Patients were predominantly African–American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer.Conclusion:In a large cohort of urban, predominantly African–American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.