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艾滋病相关恶性肿瘤:从流行病学到治疗挑战。

Malignancies in HIV/AIDS: from epidemiology to therapeutic challenges.

机构信息

aSection of Hematology/Oncology, Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Ruth M. Rothstein CORE Center, Developmental Center for AIDS Research bDepartment of Internal Medicine, Rush University Medical Center, Chicago, Illinois cDivision of Hematology and Oncology, Virginia Mason Medical Center, and the Division of Hematology, University of Washington, Seattle, Washington dDepartment of Immunology/Microbiology, Rush University Cancer Center, Developmental Center for AIDS Research, Rush University Medical Center, Chicago, Illinois, USA. *Paul G. Rubinstein and David M. Aboulafia contributed equally to the writing of this article.

出版信息

AIDS. 2014 Feb 20;28(4):453-65. doi: 10.1097/QAD.0000000000000071.

Abstract

The incidence of AIDS-defining cancers (ADCs) - Kaposi sarcoma, primary central nervous system lymphoma, non-Hodgkin lymphoma, and cervical cancer - although on the decline since shortly after the introduction of HAART, has continued to be greater even in treated HIV-infected persons than in the general population. Although the survival of newly infected people living with HIV/AIDS now rivals that of the general population, morbidity and mortality associated with non-AIDS-defining cancers (NADCs) such as lung, liver, anal, and melanoma are significant and also continue to rise. Increasing age (i.e. longevity) is the greatest risk factor for NADCs, but longevity alone is not sufficient to fully explain these trends in cancer epidemiology. In this review, we briefly review the epidemiology and etiology of cancers seen in HIV/AIDS, and in this context, discuss preclinical research and broad treatment considerations. Investigation of these considerations provides insight into why malignancies continue to be a major problem in the current era of HIV/AIDS care.

摘要

艾滋病定义性癌症(ADCs)的发病率——卡波济肉瘤、原发性中枢神经系统淋巴瘤、非霍奇金淋巴瘤和宫颈癌——尽管在 HAART 问世后不久就开始下降,但即使在接受治疗的 HIV 感染者中,其发病率仍高于普通人群。虽然新感染艾滋病毒/艾滋病的人的存活率现在与普通人群相当,但与非艾滋病定义性癌症(NADCs)相关的发病率和死亡率,如肺癌、肝癌、肛门癌和黑色素瘤,仍然很严重,并且还在继续上升。年龄增长(即长寿)是 NADCs 的最大风险因素,但仅长寿本身并不能完全解释癌症流行病学中的这些趋势。在这篇综述中,我们简要回顾了 HIV/AIDS 中所见癌症的流行病学和病因,并在这方面讨论了临床前研究和广泛的治疗考虑。对这些考虑因素的研究提供了一些见解,说明为什么恶性肿瘤在当前的 HIV/AIDS 护理时代仍然是一个主要问题。

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