Fantry Lori E, Nowak Rebecca G, Fisher Lydia H, Cullen Nicole R, Yimgang Doris Prisca, Stafford Kristen A, Riedel David J, Kang Minji, Innis Ellen K, Riner Andrea, Wang Elizabeth W, Charurat Manhattan E
1 Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland.
2 Institute of Human Virology, University of Maryland School of Medicine , Baltimore, Maryland.
AIDS Res Hum Retroviruses. 2016 Sep;32(9):860-7. doi: 10.1089/AID.2015.0322. Epub 2016 Jul 21.
As HIV-infected patients live longer, non-AIDS-defining cancers are now a major cause of morbidity and mortality. The purpose of this study was to compare the prevalence, type, and location of colorectal neoplastic lesions found on colonoscopy in HIV-infected patients from an urban U.S. cohort with non-HIV-infected patients.
We collected clinical data and colonoscopy findings on 263 HIV-infected patients matched with 657 non-HIV-infected patients on age, race, and sex. Frequency distributions and descriptive statistics were used to characterize the study population. The primary exposure was HIV infection, and the primary outcome was any adenoma or adenocarcinoma. Logistic regression models were used to estimate odds ratios with 95% confidence intervals (CIs).
Participants were primarily African American and 40% were women. HIV-infected patients were less likely to have any neoplastic lesions (21.3% vs. 27.7%, p < .05), adenoma (20.5% vs. 27.1%, p = .04), tubular adenomas >10 mm (0.4% vs. 2.9%, p = .02), and serrated adenomas (0.0% vs.2.6%, p = <.01). There was a nonsignificant increased prevalence of adenocarcinoma in HIV-infected individuals compared with non-HIV-infected individuals (1.5% vs. 0.8%, p = .29). The lower prevalence of any adenoma remained after controlling for age, sex, smoking status, body-mass index, and diabetes mellitus [adjusted odds ratio (aOR), 0.61; 95% CI, 0.43-0.88]. HIV-infected patients had a lower prevalence of colorectal neoplastic lesions, including high-risk adenomas, than non-HIV-infected patients.
Our findings suggest that HIV infection in a primarily African American population is associated with a lower prevalence of colorectal adenomas, but not adenocarcinoma, found by colonoscopy.
随着感染HIV的患者寿命延长，非艾滋病定义性癌症现已成为发病和死亡的主要原因。本研究的目的是比较美国城市队列中感染HIV的患者与未感染HIV的患者在结肠镜检查中发现的结直肠肿瘤性病变的患病率、类型和位置。
我们收集了263例感染HIV患者的临床数据和结肠镜检查结果，这些患者在年龄、种族和性别上与657例未感染HIV的患者相匹配。使用频率分布和描述性统计来描述研究人群。主要暴露因素是HIV感染，主要结局是任何腺瘤或腺癌。使用逻辑回归模型估计比值比及其95%置信区间（CI）。
参与者主要是非洲裔美国人，40%为女性。感染HIV的患者发生任何肿瘤性病变的可能性较小（21.3%对27.7%，p<0.05）、腺瘤（20.5%对27.1%，p=0.04）、直径>10mm的管状腺瘤（0.4%对2.9%，p=0.02）和锯齿状腺瘤（0.0%对2.6%，p<0.01）。与未感染HIV的个体相比，感染HIV的个体中腺癌的患病率虽有增加但无统计学意义（1.5%对0.8%，p=0.29）。在控制年龄、性别、吸烟状况、体重指数和糖尿病后，任何腺瘤的较低患病率仍然存在[调整后的比值比（aOR）为0.61；95%CI为0.43-0.88]。与未感染HIV的患者相比，感染HIV的患者结直肠肿瘤性病变（包括高危腺瘤）的患病率较低。
我们的研究结果表明，在主要为非洲裔美国人的人群中，HIV感染与结肠镜检查发现的结直肠腺瘤患病率较低有关，但与腺癌无关。
