Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, USA.
AIDS. 2011 Sep 10;25(14):1771-7. doi: 10.1097/QAD.0b013e328349c67a.
Experimental studies suggested that HMG-CoA reductase inhibitors ('statins') may have antilymphoma properties. We investigated whether statin use is associated with reduced risk of non-Hodgkin lymphoma (NHL) in HIV-positive persons.
A nested case-control study was conducted among HIV-positive members of Kaiser Permanente California, a large managed care organization.
Cases were incident HIV+ NHL diagnosed from 1996 to 2008. Controls were HIV-positive members without NHL matched 5 : 1 to cases by age, sex, race, index year and known duration of HIV infection. Data were collected from Kaiser Permanente's electronic medical records. Conditional logistic regression was used to examine the effect of statin use on HIV + NHL risk, adjusting for potential confounders (matching factors, prior clinical AIDS diagnosis, antiretroviral use, baseline CD4 cell count, and history of selected co-morbidity) and use of nonstatin lipid-lowering therapy (LLT).
A total of 259 cases and 1295 controls were included. Eight percent of the cases and 14% of the controls had a history of statin use. Statin use was associated with lower risk of HIV + NHL; hazard ratio and 95% confidence intervals for ever use, less than 12, and at least 12 months cumulative use was 0.55 (0.31-0.95), 0.64 (0.31-1.28), and 0.50 (0.23-1.10), respectively. P value for trend for duration of statin use was 0.08. No association between nonstatin LLT use and risk of NHL was observed.
Our results suggested an inverse association between statin use and risk of NHL in HIV-positive persons. Potential limitations include the likelihood of residual confounding by indication and limited study power for some statin use subgroups.
实验研究表明，羟甲基戊二酰辅酶 A 还原酶抑制剂（“他汀类药物”）可能具有抗淋巴瘤特性。我们研究了他汀类药物的使用是否与艾滋病毒阳性者中非霍奇金淋巴瘤（NHL）的风险降低有关。
在加利福尼亚州凯撒永久医疗保健组织的一个大型管理式医疗组织中，对艾滋病毒阳性者进行了一项嵌套病例对照研究。
病例是在 1996 年至 2008 年期间诊断出的艾滋病毒阳性 NHL 患者。对照者是艾滋病毒阳性且没有 NHL 的患者，他们通过年龄、性别、种族、指数年和已知的艾滋病毒感染时间与病例进行 5：1 匹配。数据来自 Kaiser Permanente 的电子病历。采用条件逻辑回归分析他汀类药物的使用对 HIV + NHL 风险的影响，同时调整了潜在的混杂因素（匹配因素、既往临床 AIDS 诊断、抗逆转录病毒药物的使用、基线 CD4 细胞计数和选定合并症的病史）和非他汀类降脂治疗（LLT）的使用。
共纳入 259 例病例和 1295 例对照。8%的病例和 14%的对照有他汀类药物使用史。他汀类药物的使用与 HIV + NHL 的风险降低相关；曾经使用、使用不足 12 个月和使用至少 12 个月累积使用的风险比和 95%置信区间分别为 0.55（0.31-0.95）、0.64（0.31-1.28）和 0.50（0.23-1.10）。他汀类药物使用时间的趋势检验 P 值为 0.08。非他汀类降脂治疗的使用与 NHL 风险之间无关联。
我们的结果表明，他汀类药物的使用与 HIV 阳性者 NHL 的风险呈负相关。潜在的局限性包括通过指示发生残余混杂的可能性以及某些他汀类药物使用亚组的研究能力有限。
