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首页> 外文期刊>AIDS Research and Human Retroviruses >Burden of non-AIDS-defining and non-virus-related cancers among HIV-infected patients in the combined antiretroviral therapy era
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Burden of non-AIDS-defining and non-virus-related cancers among HIV-infected patients in the combined antiretroviral therapy era

机译：联合抗逆转录病毒疗法时代，HIV感染患者中非艾滋病定义和非病毒相关癌症的负担

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The risk of cancer is substantially increased in HIV-infected patients. However, little is known about non-AIDS-defining cancers (NADCs) without an infectious etiology. A total of 5,090 HIV-infected patients registered in the Local Health Authority (LHA) of Brescia and receiving primary care at our clinic were included in a retrospective (1999-2009) analysis. The cancer diagnoses were obtained through a record-linkage procedure between our database and the LHA general database and population-based Cancer Registry of LHA. We compared risks of these malignancies with those of the general population living in the same health area by using age-standardized incidence ratios (SIRs). Poisson regression analysis was used to assess factors associated with non-virus-related NADCs. We recorded an increase in the SIR of non-virus-related NADCs over time, with 138 cancers diagnosed in 131 patients. The mean incidence rate was 42.6/10,000 person years and the median age at the diagnosis was 49 (range, 28-78) years old. Stratifying for gender, only HIV-infected males had an increased risk of non-virus-related NADCs [SIR=1.86; 95% confidence interval (CI), 1.55-2.26]. Risk was higher for lung (SIR=3.59; 95% CI, 2.36-5.45) and testis cancer (SIR=3.11; 95% CI, 1.48-6.52). However, cancers of the prostate and breast in HIV-positive men and women were null (SIR=1.10; 95% CI, 0.53-2.32 and SIR=0.91; 95% CI, 0.47-1.74, respectively). The only predictors of non-virus-related NADCs included older age [incidence rate ratio (IRR)=1.10; 95% CI, 1.08-1.12 per each additional year, p0.001] and a shorter or no exposition to combined antiretroviral therapy (cART) (IRR=2.31; 95% CI, 1.38-3.89, p=0.002). A CD4+ count lower than 50/mm3 was significantly associated with cancers only in the univariate model (IRR=1.40; 95% CI, 0.99-1.98, p=0.057). HIV-infected men showed a 2-fold increased risk of non-virus-related NADCs compared to the general population. However, the use of cART appeared to be beneficial in protecting against the development of these malignancies.
机译：HIV感染患者的癌症风险大大增加。然而，对于没有感染病因的非艾滋病定义癌症（NADC）知之甚少。回顾性分析（1999-2009年）包括在布雷西亚地方卫生局（LHA）注册并在我们诊所接受初级护理的5,090例艾滋病毒感染患者。癌症诊断是通过我们数据库与LHA通用数据库以及基于人群的LHA癌症登记处之间的记录链接程序获得的。我们使用年龄标准化的发病率（SIR），将这些恶性肿瘤的风险与生活在同一医疗区的一般人群的风险进行了比较。泊松回归分析用于评估与非病毒相关的NADC相关的因素。我们记录了与病毒无关的NADC的SIR随时间增加，在131例患者中诊断出138例癌症。平均发病率为42.6 / 10,000人年，诊断时的中位年龄为49岁（28-78岁）。按性别分层，只有受艾滋病毒感染的男性罹患与病毒无关的非传染性疾病的风险增加[SIR = 1.86; 95％置信区间（CI），1.55-2.26]。肺癌（SIR = 3.59; 95％CI，2.36-5.45）和睾丸癌（SIR = 3.11; 95％CI，1.48-6.52）的风险更高。但是，在HIV阳性的男性和女性中，前列腺癌和乳腺癌均无效（分别为SIR = 1.10; 95％CI，0.53-2.32和SIR = 0.91; 95％CI，0.47-1.74）。与病毒无关的NADC的唯一预测因子​​包括年龄[发生率[IRR] = 1.10; 95％CI，每增加一年1.08-1.12，p <0.001]，并且暴露于联合抗逆转录病毒疗法（cART）的时间更短或没有暴露（IRR = 2.31; 95％CI，1.38-3.89，p = 0.002）。仅在单变量模型中，低于50 / mm3的CD4 +计数与癌症显着相关（IRR = 1.40; 95％CI，0.99-1.98，p = 0.057）。与普通人群相比，感染了艾滋病毒的男性与非病毒相关的NADC的患病风险增加了2倍。但是，使用cART似乎有助于预防这些恶性肿瘤的发展。

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