Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Kbh Ø, Denmark.
BMC Cancer. 2011 Jun 25;11:272. doi: 10.1186/1471-2407-11-272.
HIV patients are known to be at increased risk of lung cancer but the risk factors behind this are unclear.
We estimated the cumulative incidence and relative risk of lung cancer in 1) a population of all Danish HIV patients identified from the Danish HIV Cohort Study (n = 5,053) and a cohort of population controls matched on age and gender (n = 50,530) (study period; 1995 - 2009) and 2) their parents (study period; 1969 - 2009). Mortality and relative risk of death after a diagnosis of lung cancer was estimated in both populations.
29 (0.6%) HIV patients vs. 183 (0.4%) population controls were diagnosed with lung cancer in the observation period. HIV patients had an increased risk of lung cancer (adjusted incidence rate ratio (IRR); 2.38 (95% CI; 1.61 - 3.53)). The IRR was considerably increased in HIV patients who were smokers or former smokers (adjusted IRR; 4.06 (95% CI; 2.66 - 6.21)), male HIV patients with heterosexual route of infection (adjusted IRR; 4.19 (2.20 - 7.96)) and HIV patients with immunosuppression (adjusted IRR; 3.25 (2.01 - 5.24)). Both fathers and mothers of HIV patients had an increased risk of lung cancer (adjusted IRR for fathers; 1.31 (95% CI: 1.09 - 1.58), adjusted IRR for mothers 1.35 (95% CI: 1.07 - 1.70)). Mortality after lung cancer diagnose was increased in HIV patients (adjusted mortality rate ratio 2.33 (95%CI; 1.51 - 3.61), but not in the parents. All HIV patients diagnosed with lung cancer were smokers or former smokers.
The risk was especially increased in HIV patients who were smokers or former smokers, heterosexually infected men or immunosuppressed. HIV appears to be a marker of behavioural or family related risk factors that affect the incidence of lung cancer in HIV patients.
已知 HIV 患者患肺癌的风险增加，但背后的风险因素尚不清楚。
我们估计了 1）从丹麦 HIV 队列研究中确定的所有丹麦 HIV 患者（n=5053）和与年龄和性别匹配的人群对照队列（n=50530）（研究期间：1995-2009 年）中肺癌的累积发病率和相对风险，以及 2）他们的父母（研究期间：1969-2009 年）中肺癌的累积发病率和相对风险。在这两个群体中，我们还估计了肺癌诊断后的死亡率和相对死亡风险。
在观察期间，29 名（0.6%）HIV 患者与 183 名（0.4%）人群对照被诊断为肺癌。HIV 患者患肺癌的风险增加（调整后的发病率比（IRR）；2.38（95%CI；1.61-3.53））。在吸烟或曾经吸烟的 HIV 患者中，IRR 明显增加（调整后的 IRR；4.06（95%CI；2.66-6.21）），异性恋途径感染的男性 HIV 患者（调整后的 IRR；4.19（2.20-7.96））和免疫抑制的 HIV 患者（调整后的 IRR；3.25（2.01-5.24））。HIV 患者的父亲和母亲患肺癌的风险均增加（父亲的调整后 IRR；1.31（95%CI：1.09-1.58），母亲的调整后 IRR 为 1.35（95%CI：1.07-1.70））。HIV 患者肺癌诊断后的死亡率增加（调整后的死亡率比 2.33（95%CI；1.51-3.61）），但父母的死亡率没有增加。所有被诊断为肺癌的 HIV 患者均为吸烟者或曾经吸烟者。
风险在吸烟或曾经吸烟、异性恋感染的男性或免疫抑制的 HIV 患者中尤其增加。HIV 似乎是影响 HIV 患者肺癌发病率的行为或家庭相关风险因素的标志物。
