Mena Álvaro, Meijide Héctor, Marcos Pedro J
Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Sergas, Universidade da Coruña, A Coruña, Spain.
Department of Internal Medicine, Hospital Quiron, A Coruña, Spain.
AIDS Rev. 2016 Jul-Sep;18(3):138-144.
The widespread use of HAART for persons living with HIV since 1996 has resulted in a dramatic decline in AIDS-related mortality. However, other comorbidities are increasing, such as metabolic disturbances or cancers, including solid organ malignancies. Among the latest, lung cancer, especially the adenocarcinoma subtype, is on the rise. HIV infection, even controlling for smoking, is an independent risk factor for developing lung cancer. HIV could promote lung cancers through immunosuppression, chronic inflammation, and a direct oncogenic effect. Smoking, lung infections, and chronic pulmonary diseases are risk factors for lung cancer. All may contribute to the cumulative incidence of lung cancer in persons living with HIV. It is double that in the general population. The role of HAART in lung cancer development in persons living with HIV is not well established. Although data supporting it could be too preliminary, persons living with HIV should be considered within high-risk groups that could benefit from screening strategies with low-dose computed tomography, especially those with airway obstruction and emphysema. Current evidence suggests that quitting smoking strategies in persons living with HIV achieve abstinence rates comparable to those in healthy HIV-negative smokers.
自1996年以来,高效抗逆转录病毒疗法(HAART)在艾滋病毒感染者中的广泛使用导致与艾滋病相关的死亡率大幅下降。然而,其他合并症却在增加,如代谢紊乱或癌症,包括实体器官恶性肿瘤。其中,肺癌,尤其是腺癌亚型,呈上升趋势。即使控制了吸烟因素,艾滋病毒感染仍是患肺癌的独立危险因素。艾滋病毒可通过免疫抑制、慢性炎症和直接致癌作用促进肺癌发生。吸烟、肺部感染和慢性肺部疾病是肺癌的危险因素。所有这些因素都可能导致艾滋病毒感染者肺癌的累积发病率升高,其发病率是普通人群的两倍。HAART在艾滋病毒感染者肺癌发生中的作用尚未明确。尽管支持这一观点的数据可能过于初步,但艾滋病毒感染者应被视为可从低剂量计算机断层扫描筛查策略中获益的高危人群,尤其是那些有气道阻塞和肺气肿的患者。目前的证据表明,艾滋病毒感染者戒烟策略的戒烟率与健康的艾滋病毒阴性吸烟者相当。