Silverberg Michael J, Abrams Donald I
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
Curr Opin HIV AIDS. 2009 Jan;4(1):42-51. doi: 10.1097/COH.0b013e32831a9875.
There is an increasing burden of non-AIDS-defining malignancies (NADMs) in the antiretroviral therapy (ART) era. The recent literature is reviewed with respect to NADM risk, ART use, and immune function.
Recent studies have increasingly focused on individual ART use, CD4 T-cell counts, and the risk of NADMs. Certain NADMs have been shown to have a reduced risk with ART use including liver, breast, colorectal, and lung cancers. NADMs associated with immunosuppression included Hodgkin's lymphoma, oral/pharynx, lung, anal, and colorectal cancers. Despite the potential protective effect of ART on some NADMs, recent studies evaluating calendar era trends have noted an increased risk of Hodgkin's lymphoma and anal cancer and no change in risk for lung cancer in the ART era.
Successful ART use and improvements in immune function for HIV-infected persons may reduce the risk of certain NADMs. However, a continued high risk in the ART era for certain cancers have been observed, including Hodgkin's lymphoma and anal cancers. Future studies should monitor trends in NADMs in HIV-infected persons in the ART era, as well as changes in the prevalence of risk factors, coinfections, and screening practices in this population.
在抗逆转录病毒治疗（ART）时代，非艾滋病定义性恶性肿瘤（NADM）的负担日益加重。本文就NADM风险、ART使用及免疫功能方面对近期文献进行综述。
近期研究越来越关注个体ART使用、CD4 T细胞计数及NADM风险。已表明某些NADM在使用ART时风险降低，包括肝癌、乳腺癌、结直肠癌和肺癌。与免疫抑制相关的NADM包括霍奇金淋巴瘤、口腔/咽癌、肺癌、肛门癌和结直肠癌。尽管ART对某些NADM有潜在保护作用，但近期评估不同时期趋势的研究指出，在ART时代霍奇金淋巴瘤和肛门癌风险增加，肺癌风险无变化。
成功使用ART及改善HIV感染者的免疫功能可能降低某些NADM的风险。然而，在ART时代某些癌症仍存在持续高风险，包括霍奇金淋巴瘤和肛门癌。未来研究应监测ART时代HIV感染者中NADM的趋势，以及该人群中危险因素、合并感染和筛查实践的患病率变化。
