Evolving epidemiology of malignancies in HIV
Evolving epidemiology of malignancies in HIV
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HIV 恶性肿瘤流行病学的演变
DOI：
10.1097/cco.0b013e32830a5080
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发表时间：
2008
影响因子：
3.4
通讯作者：
G. Chêne
中科院分区：
文献类型：
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作者：
F. Bonnet;G. Chêne
综述的目的HIV感染者中与恶性肿瘤相关的发病率和死亡率正在增加。我们的目的是回顾文献的艾滋病定义和非艾滋病定义的恶性肿瘤的发病率的最新变化和艾滋病毒感染患者中出现的主要癌症的具体特征。目前，恶性肿瘤是艾滋病毒感染者最常见的潜在死亡原因（约三分之一）。自采用抗逆转录病毒联合疗法以来，卡波西肉瘤和脑淋巴瘤（在艾滋病界定的癌症中）的发病率与艾滋病界定的感染同时下降，而系统性非霍奇金淋巴瘤和宫颈癌的发病率下降幅度小于其他疾病，艾滋病毒感染患者的发病率仍然高于一般人口。最近的大型研究也表明，与普通人群相比，艾滋病毒感染患者发生非艾滋病恶性肿瘤的风险高出1.7-3倍，而抗逆转录病毒联合疗法对这些趋势没有显著影响。这些恶性肿瘤包括霍奇金病、肺癌、肛门癌、头颈癌、血液病和结膜癌。此外，在受恶性肿瘤影响的HIV感染患者中报告的较差预后可能被解释为晚期筛查或免疫抑制的结果。预防和筛查管理程序需要根据对艾滋病毒感染人群的具体循证研究进行评估。已知在其他人群中有效的干预措施应系统地使用或在必要时进行调整（酒精和烟草戒烟计划和病毒合并感染管理）。HIV本身、免疫抑制和抗逆转录病毒药物作为促癌因子的各自作用需要进一步研究。
Purpose of review Morbidity and mortality related to malignancy are increasing in HIV-infected patients. We aim at reviewing the literature on recent changes in the incidence of AIDS-defining and non-AIDS-defining malignancies and the specific characteristics of the main cancers emerging in HIV-infected patients. Recent findings Currently, malignancies are the most frequent underlying cause of death (around one-third) of HIV-infected patients. Since the introduction of combination antiretroviral therapy, the incidence of Kaposi's sarcoma and cerebral lymphoma (among AIDS-defining cancers) decreased in parallel with AIDS-defining infections, whereas the incidence of systemic non-Hodgkin's lymphoma and cervical cancer decreased less than others and remains higher in HIV-infected patients than in the general population. The most recent and large studies have also shown a 1.7–3-fold higher risk of developing non-AIDS malignancies in HIV-infected patients as compared with the general population without a significant impact of combination antiretroviral therapy on these trends. These malignancies include Hodgkin's disease, lung, anal, head and neck cancers, hemopathies, and conjunctival cancers. In addition, the poorer prognosis reported in HIV-infected patients affected by malignancies might be interpreted as a consequence of late screening or immunosuppression. Summary Prevention and screening management procedures need to be assessed on the basis of specific evidence-based studies in the HIV-infected population. Interventions, known to be efficacious in other populations, should systematically be used or adapted if necessary (alcohol and tobacco cessation programs and viral coinfection management). The respective role of HIV itself, immunosuppression, and antiretrovirals as pro-oncogenic factors need to be further examined.
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影响因子：
20.3
作者：
Biggar, Robert J.;Jaffe, Elaine S.;Engels, Eric A.
通讯作者：
Engels, Eric A.
影响因子：
11.8
作者：
Kirk, Gregory D.;Merlo, Christian;Engels, Eric A.
通讯作者：
Engels, Eric A.
影响因子：
45.3
作者：
PRESS, OW;EARY, JF;BERNSTEIN, ID
通讯作者：
BERNSTEIN, ID
纽约大学医学中心（美国）
DOI：
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