Human papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome
Human papillomavirus-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome
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DOI：
10.1093/jnci/92.18.1500
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发表时间：
2000-09-20
影响因子：
10.3
通讯作者：
Goedert, JJ
中科院分区：
文献类型：
--
作者：
Frisch, M;Biggar, IJ;Goedert, JJ
背景资料：人乳头瘤病毒（HPV）相关的肛门生殖器恶性肿瘤经常发生在人类免疫缺陷病毒（HIV）感染和获得性免疫缺陷综合征（AIDS）患者中。我们研究的目的是确定这些癌症的高发病率是否是由于与HPV和HIV感染相关的生活方式因素或HIV感染后的免疫抑制造成的。研究方法：我们研究了309365例美国HIV感染/AIDS患者（257605例男性和51760例女性）中的浸润性和原位HPV相关性癌症，这些患者从AIDS发病日期前5年到该日期后5年。性别、种族和年龄标准化的预测癌症与预期癌症的比率作为相对风险（RR）的指标。趋势检验被用来评估在艾滋病发病的10年期间RR的变化。所有统计学检验均为双侧检验。结果：与预期的癌症数量相比，艾滋病患者中所有HPV相关癌症的发生率在统计学上显著增加。对于原位癌，宫颈癌的总体风险显著增加，（RR = 4.6; 95%置信区间[CI] = 4.3-5.0），外阴/阴道（RR = 3.9; 95% CI = 2.0-7.0），分析（女性，RR = 7.8 [95% CI = 0.2-43.6];男性，RR = 60.1 [95% CI = 49.2- 72.7]）和阴茎（RR = 6.9; 95%CI = 4.2-10.6）癌症，并且在跨越AIDS发病的10年期间，宫颈原位癌的RR增加（P趋势
Background: Human papillomavirus (HPV)-associated anogenital malignancies occur frequently in patients with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS). The purpose of our study was to determine if the high frequency of these cancers is due to lifestyle factors associated with both HPV and HIV infections or to immunosuppression following HIV infection. Methods: We studied invasive and in situ HPV-associated cancers among 309365 U.S. patients with HIV infection/AIDS (257605 males and 51760 females) from 5 years before the date of AIDS onset to 5 years after this date. Sex-, race-, and age-standardized ratios of observed-to-expected cancers served as measures of relative risk (RR). Trend tests were used to evaluate changes in the RRs during the 10 years spanning AIDS onset. All statistical tests were two-sided. Results: All HPV-associated cancers in AIDS patients occurred in statistically significant excess compared with the expected numbers of cancers. For in situ cancers, overall risks were significantly increased for cervical (RR = 4.6; 95% confidence interval [CI] = 4.3-5.0), vulvar/vaginal (RR = 3.9; 95% CI = 2.0-7.0), anal (in females, RR = 7.8 [95% CI = 0.2-43.6]; in males, RR = 60.1 [95% CI = 49.2- 72.7]), and penile (RR = 6.9; 95% CI = 4.2-10.6) cancers, and RRs increased during the 10 years spanning AIDS onset for carcinomas in situ of the cervix (P for trend