Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART era: impact of immunosuppression.
Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART era: impact of immunosuppression.
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DOI：
10.1097/qai.0b013e3181b033ab
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发表时间：
2009-10-01
期刊：
影响因子：
--
通讯作者：
Justice AC
中科院分区：
文献类型：
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作者：
Bedimo RJ;McGinnis KA;Dunlap M;Rodriguez-Barradas MC;Justice AC
据报道，在HAART时代，非艾滋病定义恶性肿瘤（non-ADM）的发生率没有变化或增加。hiv感染者的非adm发生率是否显著高于未感染hiv的患者尚不清楚。从1997年到2004年，我们计算了一组治疗艾滋病毒感染者的退伍军人和年龄、种族和性别匹配的未感染患者的恶性肿瘤发病率。对于感染艾滋病毒的患者，比较了有癌症和没有癌症的患者最接近第一次观察日期的CD4计数。33,420名艾滋病毒感染者和66,840名未感染艾滋病毒的患者随访时间中位数为5.1年和6.4年。hiv感染者与未感染者的发病率比[IRR]为1.6 （1260 vs 841/ 100000人年；95% CI: 1.5-1.7）。个体癌症的IRR最高的是肛门癌（14.9;CI: 10.1-22.1）。在hiv感染患者中，非adm患者（249 vs 270, p=0.02）、肛门癌患者（154 vs 270, p<0.001）和霍奇金淋巴瘤患者（217 vs 270, p=0.03）的中位CD4计数较低。前列腺癌与较高的CD4计数相关（310比270；p<0.001）。在HAART时代，hiv感染者中非adms的发生率高于hiv未感染者，调整了年龄、种族和性别。一些非adms似乎与CD4计数明显降低无关。
The incidence of non-AIDS-defining malignancies (non-ADM) is reported as unchanged or increasing in the HAART era. Whether incidence of non-ADM is significantly higher in HIV-infected than in HIV-uninfected patients remains unclear. Incidence rates of malignancies were calculated in a cohort of veterans in care for HIV-infected and age, race, and gender-matched uninfected patients from 1997 to 2004. For HIV-infected patients CD4 counts closest to first observation date were compared between those with and without cancer. 33,420 HIV-infected and 66,840 HIV-uninfected patients were followed for a median of 5.1 and 6.4 years. The Incidence rate ratio [IRR] of HIV-infected to HIV-uninfected was 1.6 (1260 vs. 841/100,000 person-years; 95% CI: 1.5–1.7). IRR for individual cancers was highest for anal cancer (14.9; CI: 10.1–22.1). Among HIV-infected patients, median CD4 counts were lower for those with non-ADM (249 vs. 270, p=0.02), anal cancer (154 vs. 270; p<0.001), and Hodgkin’s (217 vs. 270; p=0.03). Prostate cancer was associated with a higher CD4 count (310 vs. 270; p<0.001). In the HAART era, the incidence of non-ADMs is higher among HIV-infected than HIV-uninfected patients, adjusting for age, race, and gender. Some non-ADMs do not appear to be associated with significantly lower CD4 counts.