Oliver Nora T, Chiao Elizabeth Y
aDepartment of Medicine, Section of Infectious Diseases, Atlanta VA Medical Center, Decatur, Georgia bDepartment of Medicine, Section of Infectious Diseases and Health Services Research, Baylor College of Medicine, Houston, Texas, USA.
Curr Opin HIV AIDS. 2017 Jan;12(1):69-76. doi: 10.1097/COH.0000000000000332.
To review current knowledge of different cancer states affecting women with HIV infection.
With improved survival of persons with HIV in the post-cART era, the landscape of malignancies in this population has greatly changed with fewer AIDS-defining malignancies (ADM) and a growing number of non-AIDS defining malignancies (NADM). Women, however, continue to represent a vulnerable population at risk for certain ADM and NADM such as cervical, anal, and breast cancer. Human papillomavirus-mediated cancers disproportionately burden women in resource-poor settings such as sub-Saharan Africa. For cancers such as Kaposi's sarcoma, lung cancer, liver cancer, and colorectal cancer, women share a lower burden of disease compared with their male counterparts. However, there remains a dearth of evidence characterizing these disease states specifically among women.
Cancer in women with HIV continues to be a major source of morbidity and mortality worldwide, especially in low-income countries. Screening strategies, primary prevention through vaccination against human papillomavirus and viral hepatitis, and treatment for HIV with combined antiviral therapy remain cornerstones in cancer prevention.
回顾影响感染HIV的女性的不同癌症状态的现有知识。
在后抗逆转录病毒治疗(cART)时代,随着HIV感染者生存率的提高,该人群的恶性肿瘤格局发生了很大变化,艾滋病定义的恶性肿瘤(ADM)减少,非艾滋病定义的恶性肿瘤(NADM)数量增加。然而,女性仍然是某些ADM和NADM(如宫颈癌、肛门癌和乳腺癌)的高危脆弱人群。在撒哈拉以南非洲等资源匮乏地区,人乳头瘤病毒介导的癌症给女性带来了不成比例的负担。对于卡波西肉瘤、肺癌、肝癌和结直肠癌等癌症,与男性相比,女性的疾病负担较低。然而,仍然缺乏专门针对女性这些疾病状态的证据。
感染HIV的女性患癌症仍然是全球发病和死亡的主要原因,尤其是在低收入国家。筛查策略、通过人乳头瘤病毒和病毒性肝炎疫苗接种进行一级预防以及联合抗病毒疗法治疗HIV仍然是癌症预防的基石。