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[人类免疫缺陷病毒感染与非艾滋病定义性恶性肿瘤:门诊临床经验]

[HIV infection and non-AIDS-defining malignancies: an outpatient clinic experience].

作者信息

Fevereiro Maria do Carmo

机构信息

Serviço de Medicina 1.4. Hospital São José. Centro Hospitalar Lisboa Central. Lisboa. Portugal..

出版信息

Acta Med Port. 2014 Mar-Apr;27(2):181-90. Epub 2014 Apr 30.

Abstract

INTRODUCTION

Human Immunodeficiency Virus infected patients have an increased risk for developing different types of cancer. After the introduction of highly active antiretroviral therapy (HAART), and consequent increased survival, a shift has been seen in the spectrum and evolution of HIV infection related diseases, particularly oncological ones, with a tendency to increase non-AIDS-defining malignancies (NADM) as opposed to AIDS defining malignancies.

MATERIAL AND METHODS

Characterization of the Human Immunodeficiency Virus infected patients with a non-AIDS defining malignancy diagnosis, followed over 16 years at an outpatient clinic in Lisbon through the review of medical records and retrospective evaluation of demographic, epidemiological, clinical and laboratorial parameters, treatment and mortality.

RESULTS

Of the 1042 patients evaluated, there were 34 Non-AIDS defining malignancy cases identified, mostly in men (78%), with a median age of 55 years. The most common cancers were: lung (20.6%), bladder (17.6%), prostate (8.8%), and anal carcinoma (5.9%). The mean time between Human Immunodeficiency Virus infection and non-AIDS-defining malignancy diagnosis was 6.8 ± 4 years. At the time of non-AIDS- defining malignancy diagnosis the majority of patients (78.8%) was receiving HAART for a mean period of 5.7 ± 3 years, most of whom were immune and virologically controlled (64%). There were 45.5% deaths, mainly in patients with lung cancer (20%).

CONCLUSION

Given the risk of developing a non-AIDS-defining malignancy in Human Immunodeficiency Virus-infected patients, it is essential to continue to invest in prevention strategies, promote smoking cessation as well as vaccination programs, as well as applying screening protocols adjusted to this population.

摘要

引言

感染人类免疫缺陷病毒(HIV)的患者患不同类型癌症的风险增加。在引入高效抗逆转录病毒疗法(HAART)并随之提高生存率之后,HIV感染相关疾病(尤其是肿瘤性疾病)的谱型和演变发生了变化,与艾滋病定义的恶性肿瘤相比,非艾滋病定义的恶性肿瘤(NADM)有增加的趋势。

材料与方法

对诊断为非艾滋病定义恶性肿瘤的HIV感染患者进行特征分析,通过回顾里斯本一家门诊诊所16年期间的病历,并对人口统计学、流行病学、临床和实验室参数、治疗及死亡率进行回顾性评估。

结果

在评估的1042例患者中,确定了34例非艾滋病定义恶性肿瘤病例,大多数为男性(78%),中位年龄为55岁。最常见的癌症为:肺癌(20.6%)、膀胱癌(17.6%)、前列腺癌(8.8%)和肛门癌(5.9%)。从HIV感染到非艾滋病定义恶性肿瘤诊断的平均时间为6.8±4年。在非艾滋病定义恶性肿瘤诊断时,大多数患者(78.8%)正在接受HAART治疗,平均治疗时间为5.7±3年,其中大多数患者免疫和病毒学指标得到控制(64%)。死亡率为45.5%,主要发生在肺癌患者中(20%)。

结论

鉴于HIV感染患者有发生非艾滋病定义恶性肿瘤的风险,继续投资于预防策略、促进戒烟以及疫苗接种计划,并应用针对该人群调整的筛查方案至关重要。

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