HIV infection and the risk of cancers with and without a known infectious cause.
HIV infection and the risk of cancers with and without a known infectious cause.
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HIV 感染以及有或没有已知感染原因的癌症风险。
DOI：
10.1097/qad.0b013e3283319184
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发表时间：
2009-11-13
期刊：
影响因子：
3.8
通讯作者：
Abrams, Donald I.
中科院分区：
文献类型：
--
作者：
Silverberg, Michael J.;Chao, Chun;Leyden, Wendy A.;Xu, Lanfang;Tang, Beth;Horberg, Michael A.;Klein, Daniel;Quesenberry, Charles P., Jr.;Towner, William J.;Abrams, Donald I.
评估艾滋病毒感染者在有或没有已知感染原因的情况下患癌症的风险。回顾性队列研究。 1996 年至 2007 年间，对 Kaiser Permanente 成年 HIV 感染者和匹配的 HIV 未感染者进行了随访，了解艾滋病定义癌症 (ADC)、感染相关的非艾滋病定义癌症 (NADC)（肛门鳞状细胞癌、阴道/外阴癌、霍奇金淋巴瘤、阴茎癌、肝癌、HPV 相关口腔/咽癌、胃癌）和 与感染无关的 NADC（所有其他 NADC）。我们确定了 20,277 名 HIV 感染者和 202,313 名 HIV 未感染者。 HIV感染者经历了552次ADC、221次感染相关NADC和388次感染无关NADC。 HIV 未感染者经历了 179 次 ADC、284 次感染相关 NADC 和 3,418 次感染无关 NADC。比较 HIV 感染者和 HIV 未感染者的 ADC 比率 (RR) 为 37.7 (95% CI: 31.7–44.8)，RR 随着时间的推移而下降 (p<0.001)。感染相关 NADC 的 RR 为 9.2 (95% CI: 7.7–11.1)，RR 也随着时间的推移而下降 (p<0.001)。这些结果很大程度上受到肛门鳞状细胞癌和霍奇金淋巴瘤的影响。与感染无关的 NADC 的 RR 为 1.3 (95% CI: 1.2–1.4)，随着时间的推移 RR 没有变化 (p=0.44)。在与感染无关的 NADC 中，HIV 感染者中其他肛门癌、皮肤癌、其他头颈癌和肺癌的发病率较高，前列腺癌的发病率较低。在所有与感染无关的 NADC 中，只有肺癌的 RR 随时间推移而下降 (p=0.007)。尽管在抗逆转录病毒治疗时代，较高的风险有所降低，但艾滋病毒感染者患已知感染原因的癌症的风险特别高。感染艾滋病毒的人中，不明感染原因的癌症略有增加。
To evaluate the risk of cancers with and without a known infectious cause in HIV-infected persons. Retrospective cohort study. Adult HIV-infected and matched HIV-uninfected members of Kaiser Permanente followed between 1996 and 2007 for incident AIDS-defining cancers (ADC), infection-related non-AIDS-defining cancers (NADC) (anal squamous cell, vagina/vulva, Hodgkin’s lymphoma, penis, liver, HPV-related oral cavity/pharynx, stomach) and infection-unrelated NADC (all other NADC). We identified 20,277 HIV-infected and 202,313 HIV-uninfected persons. HIV-infected persons experienced 552 ADC, 221 infection-related NADC, and 388 infection-unrelated NADC. HIV-uninfected persons experienced 179 ADC, 284 infection-related NADC, and 3,418 infection-unrelated NADC. The rate ratio (RR) comparing HIV-infected and HIV-uninfected persons for ADC was 37.7 (95% CI: 31.7–44.8), with decreases in the RR over time (p<0.001). The RR for infection-related NADC was 9.2 (95% CI: 7.7–11.1), also with decreases in the RR over time (p<0.001). These results were largely influenced by anal squamous cell cancer and Hodgkin’s lymphoma. The RR for infection-unrelated NADC was 1.3 (95% CI: 1.2–1.4), with no change in the RR over time (p=0.44). Among infection-unrelated NADC, other anal, skin, other head and neck, and lung cancer rates were higher and prostate cancer rates lower in HIV-infected persons. Among all infection-unrelated NADC, the RR decreased over time only for lung cancer (p=0.007). HIV-infected persons are at particular risk for cancers with a known infectious cause, although the higher risk has decreased in the antiretroviral therapy era. Cancers without a known infectious cause are modestly increased in HIV-infected persons.