Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
AIDS Rev. 2013 Oct-Dec;15(4):237-8.
Starting antiretroviral therapy (ART) with low CD4 counts raises the likelihood of certain cancers, but others increase with longer time on therapy, reflecting the rising risk associated with older age. Researchers in the USA looked at patterns of cancer incidence and timing after ART initiation (Yanik, et al. Clin Infect Dis. 2013;57:756-64). The analysis included medical records from 11,485 participants in eight U.S. HIV clinical cohorts who started ART between 1996 and 2011. Around 80% were male and they started treatment at a median age of 38 years. At the time of ART initiation, the median CD4 count was 202 cells/mm3. Nearly half started a protease inhibitor regimen. The authors looked at incidence rates for AIDS-defining cancers (Kaposi sarcoma [KS], non-Hodgkin's lymphoma, and cervical cancer) and non-AIDS cancers. They separately assessed cancers caused by viruses, such as hepatocellular carcinoma caused by hepatitis B or C, lymphoma related to Epstein-Barr virus, and cervical or anal cancer caused by human papillomavirus (HPV).
开始抗逆转录病毒疗法（ART）时 CD4 计数较低会增加某些癌症的可能性，但其他癌症的风险随着治疗时间的延长而增加，这反映了与年龄增长相关的风险增加。美国的研究人员研究了 ART 启动后癌症发病率和发病时间的模式（Yanik 等人，Clin Infect Dis. 2013;57:756-64）。该分析包括来自 11485 名参与者的医疗记录，这些参与者参加了 8 个美国 HIV 临床队列，他们在 1996 年至 2011 年间开始接受 ART。大约 80%是男性，他们在 38 岁的中位数年龄开始治疗。在开始 ART 时，中位数 CD4 计数为 202 个细胞/mm3。近一半的人开始使用蛋白酶抑制剂方案。作者观察了 AIDS 定义的癌症（卡波西肉瘤[KS]、非霍奇金淋巴瘤和宫颈癌）和非 AIDS 癌症的发病率。他们分别评估了由病毒引起的癌症，如乙型肝炎或丙型肝炎引起的肝细胞癌、与 Epstein-Barr 病毒相关的淋巴瘤，以及人乳头瘤病毒（HPV）引起的宫颈癌或肛门癌。
