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[HIV 感染患者的恶性肿瘤:1993 年至 2010 年间 129 例病例的描述性研究]

[Malignancies in HIV-infected patients: descriptive study of 129 cases between 1993 and 2010].

作者信息

Meijide Héctor, Mena Alvaro, Pernas Berta, Castro Angeles, López Soledad, Vázquez Pilar, Bello Laura, Baliñas Josefa, Rodríguez-Martínez Guillermo, Pedreira José D

机构信息

Servicio de Medicina Interna, Hospital Universitario de A Coruña, A Coruña, España.

出版信息

Rev Chilena Infectol. 2013 Apr;30(2):156-61. doi: 10.4067/S0716-10182013000200006.

Abstract

INTRODUCTION

The development of malignancies is a problem associated with HIV infection. The incidence and spectrum of malignancies has been modified with the addition of highly active antiretroviral therapy (HAART).

AIM

To describe the clinical and epidemiological characteristics and prognosis of HIV patients who have developed a malignancy.

METHODS

Retrospective observational study was conducted in HIV + patients who developed a malignancy between 1993-2010 in a referral hospital. AIDS-defining malignancies (ADN) and non-AIDS-defining malignancies (NADN) were compared.

RESULTS

125 patients were identified with at least one malignancy. The most frequent malignancies were: non-Hodgkin lymphoma (n; 39; 30.2%), Kaposi's sarcoma (n: 20; 15.5%), Hodgkin's disease (n: 11; 8.8%), lung cancer (n: 20; 15.5%) and hepatocellular carcinoma (n: 9; 6.9 %). The mean age was 42 ± 11 years, 84% male, 55.8% were coinfected with HBV and or HCV. The risk behaviors were: 45.6% intravenous drug users, 16.8% men who have sex with men and 20% heterosexuals). There were 67 (52%) NADN and 62 (48%) ADN; NADN patients had a longer story of HIV infection and longer exposure to HAART, better level of immunodeficiency and better virological control than ADN patients. Four patients developed a second malignancy. Overall survival was 34.7%.

CONCLUSIONS

We found an increased incidence of NADN, appearing in patients with better virological and immunological control than ADN group. Mortality of patients with HIV infection and malignancy is still very high.

摘要

引言

恶性肿瘤的发生是与HIV感染相关的一个问题。随着高效抗逆转录病毒治疗(HAART)的应用,恶性肿瘤的发病率和谱发生了改变。

目的

描述发生恶性肿瘤的HIV患者的临床和流行病学特征及预后。

方法

对1993年至2010年在一家转诊医院发生恶性肿瘤的HIV阳性患者进行回顾性观察研究。比较了艾滋病相关恶性肿瘤(ADN)和非艾滋病相关恶性肿瘤(NADN)。

结果

确定了125例至少患有一种恶性肿瘤的患者。最常见的恶性肿瘤为:非霍奇金淋巴瘤(n = 39;30.2%)、卡波西肉瘤(n = 20;15.5%)、霍奇金病(n = 11;8.8%)、肺癌(n = 20;15.5%)和肝细胞癌(n = 9;6.9%)。平均年龄为42±11岁,84%为男性,55.8%合并感染HBV和/或HCV。危险行为包括:45.6%为静脉吸毒者,16.8%为男男性行为者,20%为异性恋者。有67例(52%)NADN和62例(48%)ADN;NADN患者的HIV感染病史更长,接受HAART的时间更长,免疫缺陷水平更好,病毒学控制比ADN患者更好。4例患者发生了第二种恶性肿瘤。总生存率为34.7%。

结论

我们发现NADN的发病率增加,出现在病毒学和免疫学控制比ADN组更好的患者中。HIV感染合并恶性肿瘤患者的死亡率仍然很高。

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