Breast Cancer and HIV in Sub-Saharan Africa: A Complex Relationship.
Breast Cancer and HIV in Sub-Saharan Africa: A Complex Relationship.
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DOI：
10.1200/jgo.2016.006585
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发表时间：
2018-09
影响因子：
--
通讯作者：
Zetola NM
中科院分区：
文献类型：
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作者：
Grover S;Martei YM;Puri P;Prabhakar P;Mutebi M;Balogun OD;Price AJ;Freeman AH;Narasimhamurthy M;Rodin D;Rayne S;Zetola NM
随着抗逆转录病毒疗法的推广，艾滋病病毒感染者的数量和寿命都显著增加。此外，女性艾滋病病毒感染者中乳腺癌的发病率正在上升，尤其是在撒哈拉以南非洲地区。然而，艾滋病病毒感染与乳腺癌之间的关联尚未得到很好的理解。
进行了文献检索，以确定发表在与乳腺癌和艾滋病相关期刊上的文章，重点是撒哈拉以南非洲地区。还确定了一些美国的研究用于比较。
在审查的56项研究中，规模最大的一项研究调查了美国314名患有乳腺癌和艾滋病的患者。关于艾滋病病毒感染在乳腺癌中是致癌因素还是抑癌因素，目前尚无共识，它可能与乳腺癌无关。据报道，高收入国家的乳腺癌发病率高于撒哈拉以南非洲地区，尽管撒哈拉以南非洲地区的乳腺癌发病年龄更年轻，且病情更晚期。一些研究表明，患有乳腺癌和艾滋病的患者比未感染艾滋病的患者经历更严重的化疗毒性。治疗结果的数据有限。规模最大的研究显示，与未感染艾滋病的患者相比，艾滋病患者的治疗结果更差。
艾滋病病毒感染与乳腺癌的不同临床表现无关。然而，一些证据表明，乳腺癌与艾滋病同时诊断与治疗相关毒性增加和更差的结果有关。需要进行系统的前瞻性研究来确定乳腺癌与艾滋病之间是否存在特定的关联。
The number and lifespan of individuals living with HIV have increased significantly with the scale-up of antiretroviral therapy. Furthermore, the incidence of breast cancer in women with HIV is growing, especially in sub-Saharan Africa (SSA). However, the association between HIV infection and breast cancer is not well understood. A literature search was performed to identify articles published in journals pertaining to breast cancer and HIV, with an emphasis on SSA. Selected US-based studies were also identified for comparison. Among the 56 studies reviewed, the largest study examined 314 patients with breast cancer and HIV in the United States. There is no consensus on whether HIV infection acts as a pro-oncogenic or antioncogenic factor in breast cancer, and it may have no relation to breast cancer. A higher incidence of breast cancer is reported in high-income countries than in SSA, although breast cancer in SSA presents at a younger age and at a more advanced stage. Some studies show that patients with breast cancer and HIV experience worse chemotherapy toxicity than do patients without HIV. Data on treatment outcomes are limited. The largest study showed worse treatment outcomes in patients with HIV, compared with their counterparts without HIV. HIV infection has not been associated with different clinical presentation of breast cancer. However, some evidence suggests that concurrent diagnosis of HIV with breast cancer is associated with increased therapy-related toxicity and worse outcomes. Systematic prospective studies are needed to establish whether there is a specific association between breast cancer and HIV.