Disparities in breast cancer risk by HIV status: An exploration of sociodemographic differences between women with and without HIV and potential viral mechanisms for breast cancer risk reduction

艾滋病毒感染状况导致乳腺癌风险的差异：探索感染艾滋病毒和未感染艾滋病毒的女性之间的社会人口统计学差异以及降低乳腺癌风险的潜在病毒机制

• 批准号: 9925882
• 负责人: Sally Behan Coburn
• 金额: $ 4.55万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9925882
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Age; Age Distribution; American; Anti-Retroviral Agents; Breast Cancer Cell; Breast Cancer Risk Factor; CXCR4 gene; Calendar; Cancer Etiology; Characteristics; Clinical; Clinical Management; Collaborations; Data Sources; Development; Diagnosis; Disease; Educational process of instructing; Epidemiology; Estradiol; Estrogens; Etiology; Fellowship; Female Breast Carcinoma; Funding; General Population; Guidelines; HIV; HIV Infections; Immunologic Receptors; Incidence; Joints; Lead; Life Expectancy; Malignant Neoplasms; Malignant neoplasm of anus; Malignant neoplasm of lung; Measurement; Mentors; Nested Case-Control Study; Pathogenesis; Pathway interactions; Perimenopause; Play; Population; Postmenopause; Prospective cohort study; Public Health Schools; Research; Research Design; Research Priority; Risk; Risk Estimate; Risk Factors; Risk Reduction; Role; Screening for cancer; Time; Training; Training Programs; United States; United States National Institutes of Health; Viral; Viral Load result; Woman; Women’s Interagency HIV Study; Work; antiretroviral therapy; breast cancer diagnosis; cancer diagnosis; cancer therapy; clinical care; clinical risk; cohort; comorbidity; doctoral student; immune function; improved; insight; malignant breast neoplasm; novel; sociodemographic factors; sociodemographics; study population

7. PROJECT SUMMARY/ABSTRACT Specific aims: There are three aims for the proposed research: 1a) To describe the cumulative incidence of breast cancer in women with antiretroviral treated HIV in 2000-2017, stratified by calendar time (2000-2005, 2006-2011, 2012-2017); 1b) To estimate the risk of breast cancer in women with antiretroviral treated HIV comparing women with high versus low viral load in 2007-2017 by sociodemographic factors; 2) To estimate differences in estrogen (estradiol) in pre and perimenopausal women with versus without HIV, and by HIV viral load among women with HIV (WHIV); 3) To determine the association between circulating estradiol and the risk of postmenopausal breast cancer in women with and without HIV. Significance: These three aims will provide novel evidence on the etiology of breast cancer, and whether HIV could play a role in cancer development. If sociodemographic differences between women with and without HIV contribute substantially to the reduced risk of breast cancer in WHIV, then the incidence of breast cancer will likely rise in WHIV, which has important implications for the clinical management of HIV in women. If HIV infection appears to contribute to this reduced risk, this research will generate hypotheses regarding the role of HIV and immune function in breast cancer etiology and potential novel mechanisms for cancer therapy. Approach: Data sources include two large, prospective cohort studies, capturing validated cancer diagnoses and relevant covariates. For Aim 1a and 1b, we will use the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) to characterize the cumulative incidence of breast cancer and its association with viral load in WHIV. The study population for Aims 2 and 3 will be the Women’s Interagency HIV Study (WIHS). For Aim 2, pre and perimenopausal women with pre-existing estradiol measurements will be utilized to assess the relationship between HIV status and estradiol, and among WHIV, the relationship between HIV viral load and estradiol. For Aim 3, a nested case-control study among postmenopausal women in the WIHS will be conducted to evaluate the relationship between HIV and estradiol on breast cancer risk. Fellowship training: Sally Coburn is a PhD student in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. The proposed research encompasses her dissertation research, which will be conducted in collaboration with the selected sponsor and three mentors offering distinct content expertise. This research is nested within a larger, comprehensive training program including coursework as well as opportunities for teaching and professional development.

7.项目总结/摘要 具体目的：拟议研究有三个目的：1a）描述 2000-2017年接受抗逆转录病毒治疗的艾滋病毒感染妇女中的乳腺癌，按日历时间分层（2000-2005年， 1b）估计接受抗逆转录病毒治疗的妇女患乳腺癌的风险 通过社会人口因素比较2007-2017年高病毒载量与低病毒载量的妇女; 2）估计 雌激素（雌二醇）在绝经前和围绝经期妇女与无艾滋病毒的差异，并通过艾滋病毒 3）确定循环雌二醇与女性艾滋病病毒感染者（WHIV）之间的关系， 绝经后妇女患乳腺癌的风险有无艾滋病毒。 意义：这三个目标将为乳腺癌的病因学提供新的证据， 可能在癌症发展中发挥作用。如果有和没有性别差异的女性 艾滋病病毒大大有助于降低乳腺癌的风险在WHIV，然后乳腺癌的发病率 在WHIV中可能会增加，这对妇女艾滋病毒的临床管理具有重要意义。如果HIV 感染似乎有助于降低风险，这项研究将产生关于感染的作用的假设。 乳腺癌病因学中的HIV和免疫功能以及癌症治疗的潜在新机制。 方法：数据来源包括两项大型前瞻性队列研究，捕获经验证的癌症诊断 和相关协变量。对于目标1a和1b，我们将利用北美艾滋病队列协作， 研究和设计（NA-ACCORD），以表征乳腺癌的累积发病率及其 与WHIV病毒载量相关。目标2和3的研究人群将是妇女机构间 艾滋病毒研究（WIHS）。对于目标2，具有既存雌二醇测量值的绝经前和围绝经期妇女将 用于评估HIV状态与雌二醇之间的关系，以及WHIV之间的关系， HIV病毒载量和雌二醇之间的关系目标3：一项在绝经后妇女中进行的巢式病例对照研究 在WIHS中进行，以评估HIV和雌二醇对乳腺癌风险的关系。 奖学金培训：Sally Coburn是约翰霍普金斯大学流行病学系的博士生 彭博公共卫生学院。拟议的研究包括她的论文研究，这将 与选定的赞助商和三位提供不同内容专业知识的导师合作进行。 这项研究是嵌套在一个更大的，全面的培训计划，包括课程，以及 教学和专业发展的机会。