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HIV感染宿主中的癌症:抗逆转录病毒时代的流行病学与发病机制

Cancer in the HIV-Infected Host: Epidemiology and Pathogenesis in the Antiretroviral Era.

作者信息

Brickman Cristina, Palefsky Joel M

机构信息

University of California San Francisco, Box 0654, 513 Parnassus Ave, Medical Science Room 420E, San Francisco, CA, 94143, USA.

出版信息

Curr HIV/AIDS Rep. 2015 Dec;12(4):388-96. doi: 10.1007/s11904-015-0283-7.

Abstract

Cancer and HIV are inextricably linked. Although the advent of antiretroviral therapy has led to a marked decline in the incidence of malignancies classically linked to immunosuppression (AIDS-defining malignancies, or ADMs), this decrease has been accompanied by a concomitant rise in the incidence of other malignancies (non-AIDS-defining malignancies, or NADMs). Population-based cancer registries provide key information about cancer epidemiology in people living with HIV (PLWH) within resource-rich countries. The risk for NADMs is elevated in PLWH compared with the general population, particularly for lung and anal cancers. Contributory factors include tobacco use, coinfection with oncogenic viruses such as human papillomavirus, and potentially direct effects of HIV itself. Data from resource-poor countries are limited and highlight the need for more studies in countries where the majority of PLWH reside. Strategies for early cancer detection and/or prevention are necessary in PLWH.

摘要

癌症与艾滋病病毒紧密相连。尽管抗逆转录病毒疗法的出现已使传统上与免疫抑制相关的恶性肿瘤(艾滋病定义的恶性肿瘤,即ADM)发病率显著下降,但这种下降伴随着其他恶性肿瘤(非艾滋病定义的恶性肿瘤,即NADM)发病率的相应上升。基于人群的癌症登记处提供了资源丰富国家中感染艾滋病病毒者(PLWH)癌症流行病学的关键信息。与普通人群相比,PLWH患NADM的风险更高,尤其是肺癌和肛门癌。促成因素包括吸烟、与致癌病毒如人乳头瘤病毒合并感染以及艾滋病病毒本身可能产生的直接影响。资源匮乏国家的数据有限,这凸显了在大多数PLWH居住的国家开展更多研究的必要性。对于PLWH而言,早期癌症检测和/或预防策略必不可少。

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