Rabkin C S, Blattner W A
Viral Epidemiology Section, National Cancer Institute, Bethesda, Maryland 20892.
Cancer Surv. 1991;10:151-60.
In populations with non-HIV immunodeficiency, non-Hodgkin lymphoma and soft tissue sarcoma, especially Kaposi's sarcoma, are the most prominent tumours, but Hodgkin's disease, gastric carcinoma, squamous cell skin cancer, malignant melanoma, hepatoma, myeloid leukaemia and/or colorectal carcinoma have been linked in various studies. Population based cancer registries and cohort studies of HIV infected persons have generally failed to detect HIV related increases in total cancer incidence or in specific tumours other than non-Hodgkin lymphoma and Kaposi's sarcoma; however, associations with anal carcinoma, hepatoma and Hodgkin's disease have been suggested by some studies. Although not indicating increased risk, HIV induced immunosuppression has been linked to an acceleration of cervical and anal neoplasia and to increased aggressiveness of Hodgkin's disease with a relative excess of the mixed cellularity type. Advances in treatment for HIV infection will delay progression to AIDS and may allow an altered natural history to emerge, including the occurrence of excesses of additional cancer types.
在患有非HIV免疫缺陷的人群中,非霍奇金淋巴瘤和软组织肉瘤,尤其是卡波西肉瘤,是最常见的肿瘤,但在各种研究中,霍奇金病、胃癌、皮肤鳞状细胞癌、恶性黑色素瘤、肝癌、髓细胞白血病和/或结肠直肠癌也与之相关。基于人群的癌症登记和对HIV感染者的队列研究,一般未能检测到HIV相关的除非霍奇金淋巴瘤和卡波西肉瘤之外的总癌症发病率或特定肿瘤的增加;然而,一些研究表明,HIV与肛管癌、肝癌和霍奇金病有关。虽然未表明风险增加,但HIV诱导的免疫抑制与宫颈和肛管肿瘤的加速发展以及霍奇金病(混合细胞型相对过多)侵袭性增加有关。HIV感染治疗的进展将延迟向艾滋病的进展,并可能使包括出现更多额外癌症类型在内的改变的自然病程显现出来。