感染艾滋病毒者的人乳头瘤病毒相关疾病
Human papillomavirus-related disease in people with HIV.
作者信息
Palefsky Joel
机构信息
University of California, San Francisco, California 94143, USA.
出版信息
Curr Opin HIV AIDS. 2009 Jan;4(1):52-6. doi: 10.1097/COH.0b013e32831a7246.
PURPOSE OF REVIEW
The incidence of human papillomavirus (HPV)-related cancers has increased among people with HIV infection compared with the general population. This review will describe recent findings in HPV-associated cancer incidence since the introduction of antiretroviral therapy, HPV/disease prevalence at sites other than cervix and anus, and recent data on screening and treatment of anal intraepithelial neoplasia.
RECENT FINDINGS
Consistent with high prevalence of anogenital HPV infection, new data on cervical intraepithelial neoplasia and anal intraepithelial neoplasia in HIV-positive men and women show that the incidence of cervical cancer has not declined since the introduction of antiretroviral therapy and that the incidence of anal cancer is rising. Several studies also highlight high rates of HPV infection and HPV-associated disease at sites other than the cervix and anus, including the penis and the mouth. Treatment methods for anal intraepithelial neoplasia have been described and show reasonable efficacy.
SUMMARY
New data imply that the problem of HPV-related cancers will not decline among HIV-positive men and women in the antiretroviral therapy era, highlighting the need to perform studies to determine if screening and treatment of anal intraepithelial neoplasia will prevent development of anal cancer. Recent data show progress in both these areas.
综述目的
与普通人群相比，人类乳头瘤病毒（HPV）相关癌症在HIV感染者中的发病率有所上升。本综述将描述自抗逆转录病毒疗法应用以来HPV相关癌症发病率的最新发现、宫颈和肛门以外部位的HPV/疾病患病率，以及肛门上皮内瘤变筛查和治疗的最新数据。
最新发现
与肛门生殖器HPV感染的高患病率一致，关于HIV阳性男性和女性宫颈上皮内瘤变和肛门上皮内瘤变的新数据表明，自抗逆转录病毒疗法应用以来，宫颈癌的发病率并未下降，且肛门癌的发病率正在上升。多项研究还强调了宫颈和肛门以外部位（包括阴茎和口腔）的HPV感染率和HPV相关疾病的高发生率。已描述了肛门上皮内瘤变的治疗方法，且显示出合理的疗效。
总结
新数据表明，在抗逆转录病毒疗法时代，HPV相关癌症问题在HIV阳性男性和女性中不会减少，这突出表明有必要开展研究，以确定肛门上皮内瘤变的筛查和治疗是否能预防肛门癌的发生。近期数据显示在这两个领域均取得了进展。
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